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精神卫生保健中的审核与反馈:工作人员的经历

Audit and feedback in mental healthcare: staff experiences.

作者信息

Pedersen Monica Stolt, Landheim Anne, Møller Merete, Lien Lars

机构信息

Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Ottestad, Norway.

Faculty of Medicine, University of Oslo , Oslo, Norway.

出版信息

Int J Health Care Qual Assur. 2018 Aug 13;31(7):822-833. doi: 10.1108/IJHCQA-08-2017-0142.

Abstract

PURPOSE

Audit and feedback (A&F) often underlie implementation projects, described as a circular process; i.e. an A&F cycle. They are widely used, but effect varies with no apparent explanation. We need to understand how A&F work in real-life situations. The purpose of this paper, therefore, is to describe and explore mental healthcare full A&F cycle experiences.

DESIGN/METHODOLOGY/APPROACH: This is a naturalistic qualitative study that uses four focus groups and qualitative content analysis.

FINDINGS

Staff accepted the initial A&F stages, perceiving it to enhance awareness and reassure them about good practice. They were willing to participate in the full cycle and implement changes, but experienced poor follow-up and prioritization, not giving them a chance to own to the process. An important finding is the need for an A&F cycle facilitator.

PRACTICAL IMPLICATIONS

Research teams cannot be expected to be involved in implementing clinical care. Guidelines will keep being produced to improve service quality and will be expected to be practiced. This study gives insights into planning and tailoring A&F cycles.

ORIGINALITY/VALUE: Tools to ease implementation are not enough, and the key seems to lie with facilitating a process using A&F. This study underscores leadership, designated responsibility and facilitation throughout a full audit cycle.

摘要

目的

审核与反馈(A&F)通常是实施项目的基础,被描述为一个循环过程,即A&F循环。它们被广泛使用,但效果各异且原因不明。我们需要了解A&F在实际情况中是如何发挥作用的。因此,本文的目的是描述和探讨精神卫生保健中完整的A&F循环体验。

设计/方法/途径:这是一项自然主义定性研究,采用了四个焦点小组和定性内容分析。

研究结果

工作人员接受了A&F的初始阶段,认为这提高了他们的意识并让他们对良好实践感到安心。他们愿意参与整个循环并实施变革,但后续跟进和优先级安排不佳,没有给他们机会主导这个过程。一个重要发现是需要一名A&F循环促进者。

实际意义

不能期望研究团队参与临床护理的实施。将不断制定指南以提高服务质量,并期望得到实践。本研究为规划和定制A&F循环提供了见解。

原创性/价值:仅靠便于实施的工具是不够的,关键似乎在于利用A&F促进一个过程。本研究强调了在整个全面审核循环中的领导力、指定责任和促进作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af8e/6290895/81ccdbaaeadd/intjhealthcarequalassur-31-0822-g001.jpg

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