Royal Roads University, Victoria, BC, Canada.
Independent Medical Consultant, Canada.
J Prim Care Community Health. 2020 Jan-Dec;11:2150132720963656. doi: 10.1177/2150132720963656.
People who use substances often mistrust the primary care system, impeding access.
To build on research clarifying how to improve patients' feelings of safety, through co-creating best practice guidelines with physicians and patient representatives.
After obtaining Research Ethics Board approval, this qualitative study engaged 22 participants including patients, physicians, and health system partners. We held a series of workshops, co-facilitated by patients and researchers, corresponding to 3 phases of the research: (1) establishment of cultural safety processes for participants during the workshops; (2) a facilitated, collaborative world café to develop guideline content; (3) validation of best practice guidelines. An implementation plan was developed and implemented. Finally, an external peer review was conducted by McGill University.
Best practices guidelines were developed giving the patient perspective on how to enhance primary care, as follows: (1) become trauma informed; (2) consider your clinical environment; (3) build a network; (4) supply an array of resources; (5) co-create a long-term treatment plan; (6) help me to stay healthy; (7) ensure timely access to specialized medical and surgical care; (8) be an advocate; (9) ask for feedback; (10) follow up. Resources were developed and disseminated.
The best practice guidelines reflect the patients' perspectives on common challenges patients have encountered, which impede their access to primary care. They support primary care physicians in providing more effective services to this challenging population of patients.
经常使用物质的人往往不信任初级保健系统，从而阻碍了他们的就诊机会。
通过与医生和患者代表共同制定最佳实践指南，进一步阐明如何增强患者的安全感，以此为基础开展研究。
在获得伦理审查委员会的批准后，这项定性研究纳入了 22 名参与者，包括患者、医生和卫生系统合作伙伴。我们举办了一系列由患者和研究人员共同主持的研讨会，对应研究的 3 个阶段：（1）为参与者在研讨会期间建立文化安全流程；（2）通过协作式的世界咖啡馆，制定准则内容；（3）验证最佳实践准则。制定并实施了实施计划。最后，麦吉尔大学进行了外部同行评审。
制定了最佳实践准则，从患者角度出发，提出了增强初级保健的建议，具体如下：（1）增强对创伤的认识；（2）考虑您的临床环境；（3）建立网络；（4）提供一系列资源；（5）共同制定长期治疗计划；（6）帮助我保持健康；（7）确保及时获得专门的医疗和手术护理；（8）成为倡导者；（9）征求反馈意见；（10）进行随访。同时还开发和传播了资源。
最佳实践准则反映了患者对常见挑战的看法，这些挑战阻碍了他们获得初级保健的机会。它们为初级保健医生为这一具有挑战性的患者群体提供更有效的服务提供了支持。
