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通过序贯模拟进行协作式医疗重塑:患者及一线工作人员视角

Collaborative healthcare remodelling through sequential simulation: a patient and front-line staff perspective.

作者信息

Weldon Sharon-Marie, Kneebone Roger, Bello Fernando

机构信息

Department Surgery and Cancer, Centre for Engagement and Simulation Science, Imperial College London, London, UK.

出版信息

BMJ Simul Technol Enhanc Learn. 2016 Jun 27;2(3):78-86. doi: 10.1136/bmjstel-2016-000113. eCollection 2016.

Abstract

BACKGROUND

The Department of health funded an initiative to pioneer new approaches that would create a more integrated form of care.

LOCAL PROBLEM

In order to receive funding, local Clinical Commissioning Groups were required to engage a range of stakeholders in a practical approach that generated the development of an integrated model of care.

INTERVENTION

Two sequential simulation (SqS) workshops comprising 65 and 93 participants, respectively, were designed using real patient scenarios from the locality, covering areas of general practice, community health and adult social care. Workshops were attended by a diverse group of stakeholders. The first workshop addressed current care pathways and the second modelled ideal care pathways generated from the data obtained at the first workshop.

METHODS

Discussions were captured through video recording, field-notes and pre and post questionnaires. Data was collated, transcribed and analysed through a combination of descriptive statistics and thematic analysis.

RESULTS

The questionnaires revealed that attendees strongly agreed that they had had an opportunity to contribute to all discussions and raise questions, concerns and ideas (100%). Pre and post knowledge of current and new models of care was vastly improved. The opportunity to share information and to network was valued, with the SqS approach seen as breaking professional barriers (100%).

CONCLUSIONS

Simulation can be used as a tool to engage stakeholders in designing integrated models of care. The systematic data collection from the diverse ideas generated also allows for a much-needed 'ear' to those providing the solutions, as well as a legitimate and balanced perspective.

摘要

背景

卫生部资助了一项倡议,以开拓新方法,创造一种更综合的护理形式。

当地问题

为了获得资金,当地临床委托小组需要以一种切实可行的方式让一系列利益相关者参与进来,从而推动综合护理模式的发展。

干预措施

设计了两个连续的模拟(SqS)研讨会,分别有65名和93名参与者,使用当地真实的患者案例,涵盖全科医疗、社区卫生和成人社会护理领域。不同的利益相关者群体参加了研讨会。第一个研讨会讨论了当前的护理路径,第二个研讨会根据在第一个研讨会上获得的数据模拟了理想的护理路径。

方法

通过录像、现场笔记以及会前和会后问卷来记录讨论情况。通过描述性统计和主题分析相结合的方式对数据进行整理、转录和分析。

结果

问卷显示,与会者强烈同意他们有机会参与所有讨论并提出问题、担忧和想法(100%)。对当前和新护理模式的会前和会后知识有了极大提高。分享信息和建立联系的机会受到重视,SqS方法被视为打破了专业壁垒(100%)。

结论

模拟可作为一种工具,让利益相关者参与设计综合护理模式。从产生的各种想法中进行系统的数据收集,也为提供解决方案的人提供了急需的“倾听渠道”,以及一个合理且平衡的视角。

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