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组织因素对姑息治疗团队信息传递的影响:结构方程建模方法。

Organizational determinants of information transfer in palliative care teams: A structural equation modeling approach.

机构信息

Department of Psychology, University of Basel, Basel, Switzerland.

School of Applied Psychology, University of Applied Sciences Northwestern Switzerland, Olten, Switzerland.

出版信息

PLoS One. 2021 Jun 3;16(6):e0252637. doi: 10.1371/journal.pone.0252637. eCollection 2021.

Abstract

Several organizational factors facilitate or hinder information transfer in palliative care teams. According to past research, organizational factors that reduce information transfer include the inconsistent use of shared electronic patient files, frequent changes of healthcare staff, a lack of opportunities for personal exchange, and a lack of evaluation of collaborative processes. Insufficient information sharing between professionals can negatively impact patient safety, whereas studies have shown that some organizational factors improve collaboration between professionals and thus contribute to improved patient outcomes. The main purpose of this study is thus to investigate whether, and if so how, organizational factors contribute to successful information exchange in palliative care teams in Switzerland, while also accounting for the different care contexts of primary and specialized palliative care. A nationwide survey was aimed at medical professionals working in palliative care. In total, 379 participants (mean age = 49.8 years, SD = 10.3) were included in this study. Two main outcome variables were examined: healthcare providers' satisfaction with information transfer in their team and their overall satisfaction with communication in their team. Hypotheses were tested by employing structural equation modeling. Findings revealed that the strongest predictors for effective information transfer in palliative care teams were sufficient opportunities for face-to-face meetings and supervision alongside feedback tools to improve collaborative practices and the application of guidelines and standards for collaboration. Face-to-face meetings were an even greater contributor to information transfer in specialized settings, whereas sharing the same work-based values with colleagues was considered more important in primary settings. Results from this study contribute to the existing literature elucidating how information transfer is facilitated in the field of palliative care. If proposed measures are implemented, this could possibly improve patient outcomes in palliative care. Furthermore, the findings can be useful for healthcare organizations and associations to make more efficient resource allocation decisions with the aim to optimize information transfer within the workforce.

摘要

有几个组织因素可以促进或阻碍姑息治疗团队中的信息传递。根据过去的研究,减少信息传递的组织因素包括:不一致地使用共享电子患者档案、医护人员频繁变动、缺乏个人交流机会以及缺乏对协作过程的评估。专业人员之间信息共享不足会对患者安全产生负面影响,而研究表明,一些组织因素可以改善专业人员之间的协作,从而有助于改善患者的预后。因此,本研究的主要目的是调查组织因素是否以及如何促进瑞士姑息治疗团队中成功的信息交流,同时考虑到初级和专门姑息治疗的不同护理环境。这项全国性调查针对的是从事姑息治疗的医疗专业人员。共有 379 名参与者(平均年龄=49.8 岁,标准差=10.3)参与了这项研究。研究考察了两个主要的结果变量:医疗保健提供者对其团队中信息传递的满意度,以及他们对团队内部沟通的总体满意度。通过结构方程模型检验了假设。研究结果表明,在姑息治疗团队中促进有效信息传递的最强预测因素是:有足够的面对面会议和监督机会,以及提供反馈工具来改善协作实践,并应用合作准则和标准。面对面会议对专门环境中的信息传递贡献更大,而与同事分享相同的工作价值观则在初级环境中更为重要。这项研究的结果为阐明姑息治疗领域中信息传递如何得到促进的现有文献做出了贡献。如果实施了所提出的措施,这可能会改善姑息治疗中的患者预后。此外,这些发现对于医疗保健组织和协会来说可能是有用的,它们可以做出更有效的资源分配决策,旨在优化劳动力内部的信息传递。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb33/8174710/26f1fa43cde9/pone.0252637.g001.jpg

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