Henwood Benjamin F, Siantz Elizabeth, Center Kimberly, Bataille Gale, Pomerance Elise, Clancy Jennifer, Gilmer Todd P
Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, US.
Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, US.
Int J Integr Care. 2020 Jun 26;20(2):15. doi: 10.5334/ijic.4737.
Practice coaches are skilled consultants who work in health care service delivery systems to make changes designed to improve patient outcomes, yet research is limited regarding their use to support integrated health care. This article describes the use of practice coaches in a large-scale effort to implement integrated care in the United States for patients with complex care needs.
This immersive, qualitative project involved five implementation team members; eight practice coaches; and 77 staff members from 12 health care organizations. Semistructured interviews were recorded and transcribed verbatim. Thematic and content analyses were applied in multiple stages to understand the use of practice coaches.
Qualitative themes about the use of practice coaching in this initiative were: (a) development of "a very rich coaching model"; (b) moving from an organic to standardized coaching approach; and (c) coaches representing the "face of the initiative."
A rich coaching model that includes an interdisciplinary coaching team can support integrated care transformation but challenges including finding highly qualified coaches and sustaining and disseminating the coaching model exist. Standardization was seen as a way to address such challenges.
Practice coaches can provide individualized, hands-on guidance to support successful implementation of integrated care.
实践指导师是在医疗服务提供系统中工作的专业顾问，致力于推动旨在改善患者治疗效果的变革，但关于他们在支持综合医疗保健方面的应用研究有限。本文描述了在美国为有复杂护理需求的患者大规模实施综合护理过程中实践指导师的使用情况。
这个沉浸式的定性项目涉及五名实施团队成员、八名实践指导师以及来自12个医疗保健组织的77名工作人员。半结构化访谈进行了录音并逐字转录。在多个阶段应用了主题分析和内容分析，以了解实践指导师的使用情况。
关于在此倡议中使用实践指导的定性主题包括：(a) 开发 “非常丰富的指导模式”；(b) 从有机指导方法向标准化指导方法转变；(c) 指导师代表 “该倡议的形象”。
一个包括跨学科指导团队的丰富指导模式可以支持综合护理转型，但存在包括寻找高素质指导师以及维持和推广指导模式在内的挑战。标准化被视为应对此类挑战的一种方式。
实践指导师可以提供个性化的亲身指导，以支持综合护理的成功实施。
