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衡量跨专业基层医疗团队的绩效:了解团队的观点。

Measuring the performance of interprofessional primary health care teams: understanding the teams perspective.

作者信息

Donnelly Catherine, Ashcroft Rachelle, Mofina Amanda, Bobbette Nicole, Mulder Carol

机构信息

School of Rehabilitation Therapy, Occupational Therapy Program, Queen's University, Kingston, ONCanada.

Faculty of Social Work, University of Toronto, Toronto, ONCanada.

出版信息

Prim Health Care Res Dev. 2019 Aug 28;20:e125. doi: 10.1017/S1463423619000409.

Abstract

AIM

The aim of the study was to describe practices that support collaboration in interprofessional primary health care teams, and identify performance indicators perceived to measure the impact of this collaboration from the perspective of interprofessional health providers.

BACKGROUND

Despite the surge of interprofessional primary health care models implemented across Canada, there is little evidence as to whether or not the intended outcomes of primary health care teams have been achieved. Part of the challenge is determining the most appropriate measures that can demonstrate the value of collaborative care. To date, little remains known about performance measurement from the providers contributing to the collaborative care process in interprofessional primary care teams. Having providers from a range of disciplinary backgrounds assist in the development of performance measures can help identify measures most relevant to demonstrate the value of collaborative care on the intended outcomes of interprofessional primary care models.

METHODS

A qualitative study; part of a larger mixed methods developmental evaluation to examine performance measurement in interprofessional primary health care teams. A stakeholder workshop was conducted at an annual association meeting of interprofessional primary health care teams in the province of Ontario, Canada. Six questions guided the workshop groups and participant responses were documented on worksheets and flip charts. All responses were collected and entered verbatim into a word document. Qualitative analytic strategies were applied to each question.

FINDINGS

A total of 283 primary health care providers from 14 health professions working in interprofessional primary health care teams participated. Top three elements of interprofessional collaboration (total n = 628) were communication (n = 146), co-treatment (n = 112) and patient-based conferences (n = 81). Top three performance indicators currently used to demonstrate the value of interprofessional collaboration (total n = 241) were patient experience (n = 71), patient health status (n = 35) and within team referrals (n = 30).

摘要

目的

本研究旨在描述支持跨专业初级卫生保健团队协作的实践,并从跨专业卫生服务提供者的角度确定被认为可衡量这种协作影响的绩效指标。

背景

尽管加拿大各地实施了大量跨专业初级卫生保健模式,但几乎没有证据表明初级卫生保健团队的预期成果是否已经实现。部分挑战在于确定能够证明协作式医疗价值的最合适措施。迄今为止,对于跨专业初级保健团队中参与协作式医疗过程的提供者的绩效评估了解甚少。让来自不同学科背景的提供者协助制定绩效指标,有助于确定最能证明协作式医疗对跨专业初级保健模式预期成果价值的指标。

方法

一项定性研究;是一项更大规模的混合方法发展性评估的一部分,旨在研究跨专业初级卫生保健团队的绩效评估。在加拿大安大略省跨专业初级卫生保健团队的年度协会会议上举办了一次利益相关者研讨会。六个问题引导各研讨小组,参与者的回答记录在工作表和活动挂图上。所有回答均被收集并逐字录入一个Word文档。对每个问题应用了定性分析策略。

结果

共有来自14个卫生专业、在跨专业初级卫生保健团队工作的283名初级卫生保健提供者参与。跨专业协作的前三大要素(总计n = 628)为沟通(n = 146)、联合治疗(n = 112)和以患者为基础的会议(n = 81)。目前用于证明跨专业协作价值的前三大绩效指标(总计n = 241)为患者体验(n = 71)、患者健康状况(n = 35)和团队内部转诊(n = 30)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ca6/6719251/e85ea2154d42/S1463423619000409_fig1.jpg

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