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加拿大以患者为中心的综合护理——改善医疗结果的政策、标准及实施工具

Integrated People-Centred Care in Canada - Policies, Standards, and Implementation Tools to Improve Outcomes.

作者信息

Sullivan-Taylor Patricia, Suter Esther, Laxton Samantha, Oelke Nelly D, Park Emma

机构信息

Strategic Policy and Partner Engagement, Health Standards Organization (HSO), Canada.

Faculty of Social Work, University of Calgary, Canada.

出版信息

Int J Integr Care. 2022 Feb 4;22(1):8. doi: 10.5334/ijic.5943. eCollection 2022 Jan-Mar.

Abstract

INTRODUCTION

Despite the national and international policy commitment to implement integrated health systems, there is an absence of national standards that support evidence-based design, implementation, and monitoring for improvement. Health Standards Organization (HSO)'s CAN/HSO 76000:2021 - (IPCHS) National Standard of Canada (NSC) has been developed to help close this gap. This manuscript outlines the policy context and the process taken to develop the IPCHS standard.

DESCRIPTION

The IPCHS standard is built around 10 design principles with detailed, action-oriented criteria and guidance for policy makers and health system partners. The IPCHS standard was co-designed with a technical committee that included balanced representation of policy makers, health system decision-makers, Indigenous leaders, providers, patients, caregivers, and academics. Additional feedback was received from a diverse audience during two public review periods and targeted consultation via interviews. This qualitative feedback, combined with the evidence reviews completed by the technical committee, informed the final content of the IPCHS standard.

DISCUSSION

The IPCHS standard was developed through a co-design process and complements existing frameworks by providing 66 detailed, action-oriented criteria, with specific guidance. The co-design process and consultations resulted in increased awareness and capacity among policy makers and health system partners. Supplementary tools are also in development to facilitate implementation and monitoring of progress and outcomes. This manuscript was developed in collaboration with technical committee members and HSO staff who led the targeted consultation and adoption of the IPCHS standard in six integrated care networks.

CONCLUSION

Implementing integration strategies requires that we create and sustain a culture of continuous improvement and learning. Key lessons from the development process focused on the importance of co-design, embedding people-centred practices throughout the standard, formal yet iterative methodology inclusive of broad consultation, clear accountability for both policy makers and system partners, tools that support action and can be adapted to local context and level of integrated system maturity.

摘要

引言

尽管国家和国际层面都有实施综合卫生系统的政策承诺,但缺乏支持基于证据的设计、实施和监测以实现改进的国家标准。卫生标准组织(HSO)的CAN/HSO 76000:2021——加拿大(IPCHS)国家标准已制定出来,以帮助填补这一空白。本手稿概述了政策背景以及制定IPCHS标准所采取的过程。

描述

IPCHS标准围绕10项设计原则构建,为政策制定者和卫生系统合作伙伴提供了详细的、注重行动的标准和指导。IPCHS标准是与一个技术委员会共同设计的,该委员会成员包括政策制定者、卫生系统决策者、原住民领袖、提供者、患者、护理人员和学者的均衡代表。在两个公众评审期以及通过访谈进行的有针对性咨询期间,还收到了来自不同受众的更多反馈。这些定性反馈与技术委员会完成的证据审查相结合,为IPCHS标准的最终内容提供了依据。

讨论

IPCHS标准是通过共同设计过程制定的,通过提供66项详细的、注重行动的标准及具体指导,对现有框架进行了补充。共同设计过程和咨询提高了政策制定者和卫生系统合作伙伴的认识和能力。还在开发补充工具,以促进对进展和成果的实施与监测。本手稿是与技术委员会成员以及HSO工作人员合作编写的,他们在六个综合护理网络中领导了IPCHS标准的有针对性咨询和采用工作。

结论

实施整合战略要求我们营造并维持持续改进和学习的文化。制定过程中的关键经验教训集中在共同设计的重要性、在整个标准中融入以人为本的做法、包括广泛咨询的正式但迭代的方法、政策制定者和系统合作伙伴明确的问责制、支持行动且可根据当地情况和综合系统成熟度进行调整的工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c8a/8815438/6369cec3cfdd/ijic-22-1-5943-g1.jpg

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