Faculty of Health Sciences, Charles Perkins Centre, University of Sydney, Sydney, Australia.
Sydney Catalyst Translational Cancer Research Centre, University of Sydney, Sydney, Australia.
Transl Behav Med. 2018 May 23;8(3):357-365. doi: 10.1093/tbm/iby022.
Providing coordinated care remains a challenge for cancer services globally. There is a lack of consensus in the literature about what constitutes successful coordinated care. This study aimed to define and prioritize a set of consensus-driven success factors that can lead to coordinated care. A mixed-methods approach was used that included literature review, a broad call for submissions from relevant stakeholders, and a priority-setting process based on a modified nominal group technique. Thirty articles that related to success factors in coordinated care were identified in the literature. Twenty submissions were received from a broad range of stakeholders. From these sources, a set of 20 success factors was derived. Seventy stakeholders attended a series of workshops across New South Wales, Australia, to review and prioritize these 20 success factors against significance and measurability. Clear consensus was reached on prioritizing two success factors linked to improving coordinated care from first presentation to diagnosis and ensuring that patients are routinely screened for physical and supportive care needs. Other highly ranked factors included the need for a comprehensive care plan and the identification of patients at higher risk for disjointed care. This study defines and prioritizes a set of success factors related to coordinated care in cancer. These success factors will be used to guide the development of interventions that target improving coordinated care as well as supporting the development of new funding models based on performance indicators derived from these factors.
提供协调一致的护理仍然是全球癌症服务的一个挑战。在文献中，对于什么构成成功的协调护理，缺乏共识。本研究旨在定义和确定一组共识驱动的成功因素，这些因素可以导致协调护理。采用了混合方法，包括文献综述、向相关利益攸关方广泛征集意见以及基于改进的名义群体技术的优先排序过程。文献中确定了 30 篇与协调护理成功因素相关的文章。从广泛的利益攸关方收到了 20 份意见书。从这些来源中得出了一套 20 个成功因素。70 名利益攸关方参加了在澳大利亚新南威尔士州举行的一系列研讨会，以审查和优先考虑这 20 个成功因素的重要性和可衡量性。在优先考虑两个成功因素方面达成了明确共识，这两个成功因素与改善从初次就诊到诊断的协调护理以及确保患者常规筛查身体和支持性护理需求有关。其他排名较高的因素包括需要制定全面的护理计划以及确定存在护理脱节风险较高的患者。本研究定义并确定了一套与癌症协调护理相关的成功因素。这些成功因素将用于指导旨在改善协调护理的干预措施的制定，并支持根据这些因素衍生的绩效指标制定新的筹资模式。
