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“改变才能让艰难的时期变得更好”:一项以患者为中心的患者安全干预措施,与医院志愿者合作实施。

"Change is what can actually make the tough times better": A patient-centred patient safety intervention delivered in collaboration with hospital volunteers.

机构信息

Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK.

School of Health Studies, University of Bradford, Bradford, UK.

出版信息

Health Expect. 2019 Feb;22(1):102-113. doi: 10.1111/hex.12835. Epub 2018 Oct 21.

Abstract

BACKGROUND

The PRASE (Patient Reporting and Action for a Safe Environment) intervention provides a way to systematically collect patient feedback to support service improvement. To provide a sustainable mechanism for the PRASE intervention, a 2-year improvement project explored the potential for hospital volunteers to facilitate the collection of PRASE feedback.

OBJECTIVE

To explore the implementation of the PRASE intervention delivered in collaboration with hospital volunteers from the perspectives of key stakeholders.

DESIGN

A qualitative case study design was utilized across three acute NHS trusts in the United Kingdom between March 2016 and October 2016. Ward level data (staff interviews; action planning meeting recordings; implementation fidelity information) were analysed taking a pen portrait approach. We also carried out focus groups with hospital volunteers and interviews with voluntary services/patient experience staff, which were analysed thematically.

RESULTS

Whilst most ward staff reported feeling engaged with the intervention, there were discordant views on its use and usefulness. The hospital volunteers were positive about their involvement, and on some wards, worked with staff to produce actions to improve services. The voluntary services/patient experience staff participants emphasised the need for PRASE to sit within an organisations' wider governance structure.

CONCLUSION

From the perspective of key stakeholders, hospital volunteers facilitating the collection of PRASE feedback is a feasible means of implementing the PRASE intervention. However, the variability around ward staff being able to use the feedback to make changes to services demonstrates that it is this latter part of the PRASE intervention cycle that is more problematic.

摘要

背景

PRASE(患者报告和安全环境行动)干预措施提供了一种系统收集患者反馈的方法,以支持服务改进。为了为 PRASE 干预措施提供一个可持续的机制,一个为期两年的改进项目探讨了医院志愿者促进 PRASE 反馈收集的潜力。

目的

从利益相关者的角度探讨与医院志愿者合作实施 PRASE 干预的情况。

设计

在 2016 年 3 月至 2016 年 10 月期间,在英国的三个 NHS 信托机构中,采用了定性案例研究设计。采用肖像法分析病房层面的数据(工作人员访谈;行动计划会议记录;实施保真度信息)。我们还与医院志愿者进行了焦点小组讨论,并对志愿服务/患者体验工作人员进行了访谈,对这些访谈进行了主题分析。

结果

尽管大多数病房工作人员对干预措施感到投入,但对其使用和有用性存在不同意见。医院志愿者对他们的参与感到满意,在一些病房,他们与工作人员合作制定了改进服务的行动。志愿服务/患者体验工作人员参与者强调,PRASE 需要置于组织的更广泛治理结构内。

结论

从利益相关者的角度来看,由医院志愿者来促进 PRASE 反馈的收集是实施 PRASE 干预的一种可行手段。然而,病房工作人员能够利用反馈来改变服务的能力存在差异,这表明 PRASE 干预措施的这后一部分更具挑战性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6b1/6351415/7b054feac6a6/HEX-22-102-g001.jpg

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