Kokorelias Kristina M, Gould Sarah, DasGupta Tracey, Cass Dan, Hitzig Sander L
St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
J Eval Clin Pract. 2022 Aug;28(4):550-557. doi: 10.1111/jep.13630. Epub 2021 Oct 18.
To explore factors influencing the implementation of patient navigator programs within a hospital for seniors with complex care needs.
A qualitative descriptive design using in-depth interviews was conducted. Participant interviews were conducted in Toronto, Ontario between September 2020 and February 2021. Data were analysed using thematic analysis.
Thirty-five semi-structured interviews were conducted with 38 participants from a large urban hospital (n = 21) and community healthcare organizations (n = 17), including organizational leaders, and acute care and rehabilitation providers. Follow-up interviews occurred with 16 participants (7 from the community and nine from the hospital). This study identified five key factors influencing organizational readiness for successful implementation of a patient navigator program for seniors with complex conditions, which included: (a) vision from senior leadership, (b) technological infrastructure, (c) existing hospital-community partnerships, (d) well-established process for referrals, and (e) staff capacity. The overarching theme of communication was also identified.
The findings of this study provide a better understanding of hospital and community professionals' needs and challenges when implementing patient navigator programs for seniors with complex care conditions. There are a number of factors that influence an organization's readiness for program uptake and delivery, with the need for clear communication being paramount. Further research to test the effects of readiness on successful implementation outcomes is warranted.
探讨影响医院内为有复杂护理需求的老年人实施患者导航计划的因素。
采用定性描述性设计并进行深入访谈。2020年9月至2021年2月期间在安大略省多伦多市进行了参与者访谈。使用主题分析法对数据进行分析。
对来自一家大型城市医院（n = 21）和社区医疗组织（n = 17）的38名参与者进行了35次半结构化访谈，参与者包括组织领导者、急性护理和康复提供者。对16名参与者（7名来自社区，9名来自医院）进行了随访访谈。本研究确定了影响为患有复杂疾病的老年人成功实施患者导航计划的组织准备情况的五个关键因素，包括：（a）高层领导的愿景，（b）技术基础设施，（c）现有的医院 - 社区伙伴关系，（d）完善的转诊流程，以及（e）员工能力。还确定了沟通这一总体主题。
本研究结果有助于更好地理解医院和社区专业人员在为患有复杂护理情况的老年人实施患者导航计划时的需求和挑战。有许多因素会影响组织对计划采用和实施的准备情况，其中清晰沟通的必要性至关重要。有必要进行进一步研究以测试准备情况对成功实施结果的影响。
