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临终关怀机构的质量改进:领导者的看法。

Quality improvement in hospice settings: perceptions of leaders.

作者信息

Singh Jitendra, Sillerud Brandi, Omar Marah

机构信息

Minnesota State University Moorhead , Moorhead, Minnesota, USA.

School of Nursing and Healthcare Leadership, Minnesota State University Moorhead , Moorhead, Minnesota, USA.

出版信息

Int J Health Care Qual Assur. 2019 Aug 12;32(7):1098-1112. doi: 10.1108/IJHCQA-04-2019-0084.

DOI:10.1108/IJHCQA-04-2019-0084
PMID:31411095
Abstract

PURPOSE

The purpose of this paper is to explore and examine attitudes and perceptions of leaders on application of quality improvement (QI) strategies in a palliative and hospice care organization.

DESIGN/METHODOLOGY/APPROACH: This study employed qualitative research methodology where leaders working in a hospice and palliative care organization were invited to participate in 45-60-min-long semi-structured interview. Interviews were recorded and transcribed verbatim. Qualitative content analysis was utilized to analyze the data collected during participant interviews.

FINDINGS

Seven leaders participated in the interviews. Five themes were developed from data analysis: patient-centered care; continuous QI; leadership involvement and commitment; communication as a foundation for QI; and perceived barriers. Data analysis suggests that use of QI approach in palliative and hospice care enhances the quality of care provided for patients, and can help improve patient satisfaction.

PRACTICAL IMPLICATIONS

Because there is a paucity of research on implementation of QI strategies in hospice and palliative care settings, this research can have wide practical implications. This research can provide useful practical tips to leaders as they work on implementing QI projects in their organization.

ORIGINALITY/VALUE: This manuscript can be of value to leaders, administrators and academicians who are interested in applying QI principles to healthcare processes especially in palliative and hospice care settings. Ability to work with others, solid communication and involvement of employees from all levels can help in streamlining current systems of care.

摘要

目的

本文旨在探讨和研究领导者对在姑息与临终关怀组织中应用质量改进(QI)策略的态度和看法。

设计/方法/途径:本研究采用定性研究方法,邀请在临终关怀与姑息治疗组织工作的领导者参与时长45至60分钟的半结构化访谈。访谈进行录音并逐字转录。运用定性内容分析法对参与者访谈期间收集的数据进行分析。

研究结果

七位领导者参与了访谈。数据分析得出五个主题:以患者为中心的护理;持续质量改进;领导参与和承诺;作为质量改进基础的沟通;以及感知到的障碍。数据分析表明,在姑息与临终关怀护理中使用质量改进方法可提高为患者提供的护理质量,并有助于提高患者满意度。

实际意义

由于在临终关怀与姑息治疗环境中实施质量改进策略的研究较少,本研究可能具有广泛的实际意义。本研究可为领导者在其组织中开展质量改进项目时提供有用的实用建议。

原创性/价值:本文稿对于有兴趣将质量改进原则应用于医疗保健流程,特别是在姑息与临终关怀环境中的领导者、管理人员和学者可能具有价值。与他人合作的能力、扎实的沟通以及各级员工的参与有助于简化当前的护理系统。

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