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成功的医疗保健跨专业网络的关键特征和关键节点——案例研究。

Key characteristics and critical junctures for successful Interprofessional networks in healthcare - a case study.

机构信息

Faculty of Health Sciences, Western University, 1151 Richmond Street, London, Ontario, N6A 3K7, Canada.

Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street, London, Ontario, N6A 3K7, Canada.

出版信息

BMC Health Serv Res. 2020 Jul 29;20(1):700. doi: 10.1186/s12913-020-05565-z.

Abstract

BACKGROUND

The use of networks in healthcare has been steadily increasing over the past decade. Healthcare networks reduce fragmented care, support coordination amongst providers and patients, improve health system efficiencies, support better patient care and improve overall satisfaction of both patients and healthcare professionals. There has been little research to date on the implementation, development and use of small localized networks. This paper describes lessons learned from a successful small localized primary care network in Southwestern Ontario that developed and implemented a regional respiratory care program (The ARGI Respiratory Health Program - ARGI is a not-for-profit corporation leading the implementation and evaluation of a respiratory health program. Respiratory therapists (who have a certified respiratory educators designation), care for patients from all seven of the network's FHTs. Patients rostered within the network of FHTs that have been diagnosed with a chronic respiratory disease are referred by their family physicians to the program. The RTs are integrated into the FHTs, and work in a triad along with patients and providers to educate and empower patients in self-management techniques, create exacerbation action plans, and act as a liaison between the patient's care providers. ARGI uses an eTool designed specifically for use by the network to assist care delivery, choosing education topics, and outcome tracking. RTs are hired by ARGI and are contracted to the participating FHTs in the network.).

METHODS

This study used an exploratory case study approach. Data from four participant groups was collected using focus groups, observations, interviews and document analysis to develop a rich understanding of the multiple perspectives associated with the network.

RESULTS

This network's success can be described by four characteristics (growth mindset and quality improvement focus; clear team roles that are strengths-based; shared leadership, shared success; and transparent communication); and five critical junctures (acknowledge a shared need; create a common vision that is flexible and adaptable depending on the context; facilitate empowerment; receive external validation; and demonstrate the impacts and success of their work).

CONCLUSIONS

Networks are used in healthcare to act as integrative, interdisciplinary tools to connect individuals with the aim of improving processes and outcomes. We have identified four general lessons to be learned from a successful small and localized network: importance of clear, flexible, and strengths-based roles; need for shared goals and vision; value of team support and empowerment; and commitment to feedback and evaluations. Insight from this study can be used to support the development and successful implementation of other similar locally developed networks.

摘要

背景

在过去十年中,医疗保健领域对网络的使用稳步增加。医疗保健网络减少了碎片化的护理,支持提供者和患者之间的协调,提高了卫生系统的效率,支持更好的患者护理,并提高了患者和医疗保健专业人员的整体满意度。迄今为止,关于小型本地化网络的实施、开发和使用的研究很少。本文介绍了安大略省西南部一个成功的小型本地化初级保健网络的经验教训,该网络开发并实施了一个区域呼吸护理计划(ARGI 呼吸健康计划-ARGI 是一个非营利性公司,负责实施和评估呼吸健康计划。呼吸治疗师(具有认证的呼吸教育者称号)为来自网络的七个 FHT 的所有患者提供护理。被家庭医生诊断患有慢性呼吸系统疾病并在网络中注册的患者被转介到该计划。RT 与 FHT 整合在一起,与患者和提供者一起组成三人小组,教育和增强患者的自我管理技术,创建恶化行动计划,并充当患者护理提供者之间的联络人。ARGI 使用专门为网络设计的电子工具来协助护理服务,选择教育主题,并进行结果跟踪。RT 由 ARGI 聘用,并与网络中的参与 FHT 签订合同。)。

方法

本研究采用探索性案例研究方法。通过焦点小组、观察、访谈和文档分析,从四个参与者群体中收集数据,以深入了解与网络相关的多种观点。

结果

该网络的成功可以用四个特征来描述(成长型思维和质量改进重点;基于优势的明确团队角色;共享领导,共同成功;透明沟通)和五个关键转折点(承认共同需求;创建一个灵活且适应背景的共同愿景;促进赋权;获得外部验证;展示工作的影响和成功)。

结论

网络在医疗保健中被用作整合的跨学科工具,将个人联系起来,旨在改善流程和结果。我们从一个成功的小型本地化网络中总结出四条一般经验教训:明确、灵活和基于优势的角色的重要性;共同目标和愿景的必要性;团队支持和赋权的价值;以及对反馈和评估的承诺。本研究的见解可用于支持其他类似本地开发网络的开发和成功实施。

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