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本文引用的文献

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Thinking outside the system: the integrated care experience in Queensland, Australia.跳出框框思考:澳大利亚昆士兰州的综合护理经验。
Aust J Prim Health. 2019 Oct;25(4):303-309. doi: 10.1071/PY18161.
2
Project INTEGRATE: Developing a Framework to Guide Design, Implementation and Evaluation of People-centred Integrated Care Processes.整合项目:构建一个指导以患者为中心的综合护理流程设计、实施与评估的框架
Int J Integr Care. 2019 Feb 1;19(1):3. doi: 10.5334/ijic.4178.
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Examining 'institutional entrepreneurship' in healthcare redesign and improvement through comparative case study research: a study protocol.通过比较案例研究探讨医疗保健重新设计与改进中的“机构创业精神”:一项研究方案
BMJ Open. 2018 Aug 5;8(8):e020807. doi: 10.1136/bmjopen-2017-020807.
4
Evaluation of an innovative tele-education intervention in chronic pain management for primary care clinicians practicing in underserved areas.评估一种创新的远程教育干预措施在慢性疼痛管理中对服务不足地区的初级保健临床医生的影响。
J Telemed Telecare. 2019 Sep;25(8):484-492. doi: 10.1177/1357633X18782090. Epub 2018 Jul 10.
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Adapting the Consolidated Framework for Implementation Research to Create Organizational Readiness and Implementation Tools for Project ECHO.调整实施研究综合框架,为ECHO项目创建组织准备情况和实施工具。
J Contin Educ Health Prof. 2018 Spring;38(2):145-151. doi: 10.1097/CEH.0000000000000195.
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Project ECHO Brings Innovation to Community Health Worker Training and Support.“拓展社区医疗成果”(ECHO)项目为社区卫生工作者培训与支持带来创新。
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行政决策:在昆士兰州试行“知识转化交流计划”(ECHO®)以整合医疗服务。

Executive Decision-Making: Piloting Project ECHO® to Integrate Care in Queensland.

作者信息

Moss Perrin, Hartley Nicole, Ziviani Jenny, Newcomb Dana, Russell Trevor

机构信息

Children's Health Queensland, South Brisbane, Queensland, AU.

The University of Queensland, South Brisbane, Queensland, AU.

出版信息

Int J Integr Care. 2020 Dec 4;20(4):23. doi: 10.5334/ijic.5512.

DOI:10.5334/ijic.5512
PMID:33335464
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7716780/
Abstract

INTRODUCTION

A Queensland project team secured grant funding to pilot Project ECHO®, a telementoring model, to drive vertical and horizontal integration across paediatric, education and primary care services. This study sought to understand what influenced healthcare executives' decision-making processes to organisationally commit to and financially invest in the pilot proposal within an organisational context.

THEORY AND METHODS

A phenomenological approach methodology was adopted to investigate healthcare executives' conscious decision-making processes. Semi-structured interviews with key stakeholders were conducted alongside project documentation analyses to create a thematic framework.

RESULTS

The qualitative thematic analysis identified five key themes that influenced the decision-making processes of healthcare executives to invest in Project ECHO® as an integrated care pilot. The themes were: (i) personal experiences, (ii) benefits, (iii) risks, (iv) partnerships, and (v) timing. Executives' reflections explored how their decision-making processes considered the intrapreneurial project team as an indicator of future sustainability.

DISCUSSION

Findings highlighted healthcare intrapreneurs' drive to foster more integrated and people-centred approaches to care. Intrapreneurial aims of financial sustainability, ongoing improvement and scalability of the proposal positively influenced investment confidence.

CONCLUSION

Intrapreneurial champions must provide a compelling narrative to convince executive decision-makers that benefits will outweigh risks, that integration is achievable through strengthened partnerships as well as future sustainability beyond the pilot phase.

摘要

引言

昆士兰的一个项目团队获得了资助资金,以试点“ECHO项目”(一种远程指导模式),推动儿科、教育和初级保健服务的纵向和横向整合。本研究旨在了解在组织背景下,哪些因素影响了医疗保健管理人员的决策过程,使其在组织层面上致力于并在财务上投资于该试点提案。

理论与方法

采用现象学方法来研究医疗保健管理人员的有意识决策过程。对关键利益相关者进行了半结构化访谈,并结合项目文件分析,创建了一个主题框架。

结果

定性主题分析确定了五个关键主题,这些主题影响了医疗保健管理人员投资“ECHO项目”作为综合护理试点的决策过程。这些主题是:(i)个人经历,(ii)益处,(iii)风险,(iv)伙伴关系,以及(v)时机。管理人员的反思探讨了他们的决策过程如何将企业内部创业项目团队视为未来可持续性的一个指标。

讨论

研究结果强调了医疗保健领域内部创业者推动采用更综合、以人为本的护理方法的动力。该提案在财务可持续性、持续改进和可扩展性方面的内部创业目标对投资信心产生了积极影响。

结论

企业内部创业的支持者必须提供有说服力的说明,以说服高管决策者,使他们相信益处将超过风险,整合可以通过加强伙伴关系以及试点阶段之后的未来可持续性来实现。