van Dongen Jerôme Jean Jacques, van Bokhoven Marloes Amantia, Goossens Wilhelmus Nicolaas Marie, Daniëls Ramon, van der Weijden Trudy, Beurskens Anna
Research Centre for Autonomy and Participation for People with Chronic Illnesses, NL.
Faculty of Health, Zuyd University of Applied Sciences, Heerlen, NL.
Int J Integr Care. 2018 Dec 13;18(4):12. doi: 10.5334/ijic.4179.
Primary care is increasingly being confronted with complex health care demands stemming from both biomedical and psychosocial problems of people with chronic diseases. Interprofessional collaboration is needed to enhance person-centredness and coordinate care provision in an efficient manner, which should eventually result in high-quality and integrated care. In primary care, collaboration often occurs through periodic interprofessional team (IPT) meetings. We have developed a multifaceted programme (including a reflection framework, training activities and a toolbox) to enhance team functioning in terms of improved person-centredness and efficiency of meetings. The aim of this study was to evaluate the perceived suitability and potential impact of this programme. Eventually, findings of this evaluation should contribute to understanding the suitability of the programme and optimizing its design.
A prospective process evaluation was conducted, using a mixed-methods approach. Six primary care IPTs participated. Data collection included observations of team meetings, semi-structured interviews with team chairpersons, a focus group meeting, and a questionnaire for all team members. Qualitative data were analysed using directed content analysis and quantitative data using descriptive statistics.
The results show that, on the whole, the programme was appreciated. Most progress was perceived regarding structure and organization. Chairs perceived increased awareness of person-centredness and team processes. They perceived the training activities as useful and instructive, and valued peer feedback and on-the-job coaching as the most effective strategies. Findings from the questionnaire showed a tendency in the desired direction for all variables.
To conclude, the programme can be considered as a suitable approach for improving team functioning. However, enhancing person-centredness requires additional training/practice and on-the-job coaching. Lastly, the programme should be context-specific, flexible in use, and preferably delivered and mediated by an external facilitator at the workplace.
基层医疗日益面临着因慢性病患者的生物医学和心理社会问题而产生的复杂医疗需求。需要跨专业协作来提高以患者为中心的程度，并以高效的方式协调医疗服务提供，最终应实现高质量的综合医疗服务。在基层医疗中，协作通常通过定期的跨专业团队（IPT）会议来进行。我们开发了一个多方面的项目（包括一个反思框架、培训活动和一个工具箱），以在提高以患者为中心的程度和会议效率方面增强团队功能。本研究的目的是评估该项目的感知适用性和潜在影响。最终，该评估的结果应有助于理解该项目的适用性并优化其设计。
采用混合方法进行前瞻性过程评估。六个基层医疗IPT参与其中。数据收集包括对团队会议的观察、对团队主席的半结构化访谈、一次焦点小组会议以及针对所有团队成员的问卷调查。定性数据采用定向内容分析法进行分析，定量数据采用描述性统计方法进行分析。
结果表明，总体而言，该项目受到好评。在结构和组织方面取得的进展最为明显。主席们意识到以患者为中心和团队流程的意识有所提高。他们认为培训活动有用且具有指导意义，并将同行反馈和在职辅导视为最有效的策略。问卷调查结果显示所有变量都朝着期望的方向发展。
总之，该项目可被视为改善团队功能的合适方法。然而，提高以患者为中心的程度需要额外的培训/实践和在职辅导。最后，该项目应因地制宜、使用灵活，最好由外部促进者在工作场所进行交付和调解。
