Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
Sociology and Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
BMJ Open. 2022 Aug 25;12(8):e060441. doi: 10.1136/bmjopen-2021-060441.
To ensure optimal implementation of person-centred quality indicators (PC-QIs), we assessed the readiness of Canadian healthcare organisations and explored their perceived barriers and facilitators to implementing and using PC-QIs.
Mixed methods.
Representatives of Canadian healthcare delivery and coordinating organisations that guide the development and/or implementation of person-centred care (PCC) measurement. Representatives from primary care clinics and organisations from the province of Alberta, Canada also participated.
We conducted a survey with representatives of Canadian healthcare organisations. The survey comprised two sections that: (1) assessed readiness for using PC-QIs, and (2) were based on the Organizational Readiness for Change Assessment tool. We summarised the survey results using descriptive statistics. We then conducted follow-up interviews with organisations representing system and clinical-level perspectives to further explore barriers and facilitators to implementing PC-QIs. The interviews were informed by and analysed using the Consolidated Framework for Implementation Research.
Thirty-three Canadian regional healthcare organisations across all 13 provinces/territories participated in the survey. Only 5 of 26 PC-QIs were considered highly feasible to implement for 75% of organisations and included: coordination of care, communication, structures to report performance, engaging patients and caregivers and overall experience. A representative sample of 10 system-level organisations and 11 primary care organisations/clinics participated in the interviews. Key barriers identified were: resources and staff capacity for quality improvement, a shift in focus to COVID-19 and health provider motivation. Facilitators included: prioritisation of PCC measurement, leadership and champion engagement, alignment with ongoing provincial strategic direction and measurement efforts, and the use of technology for data collection, management and reporting.
Despite high interest and policy alignment to use PC-QI 'readiness' to implement them effectively remains a challenge. Organisations need to be supported to collect, use and report PCC data to make the needed improvements that matter to patients.
为确保以患者为中心的质量指标（PC-QIs）的最佳实施，我们评估了加拿大医疗机构的准备情况，并探讨了他们在实施和使用 PC-QIs 方面的感知障碍和促进因素。
混合方法。
代表加拿大医疗保健服务和协调组织，这些组织指导以患者为中心的护理（PCC）测量的制定和/或实施。来自加拿大艾伯塔省初级保健诊所和组织的代表也参加了会议。
我们对加拿大医疗机构的代表进行了一项调查。该调查由两部分组成：（1）评估使用 PC-QIs 的准备情况；（2）基于组织变革准备评估工具。我们使用描述性统计数据总结了调查结果。然后，我们对代表系统和临床层面的组织进行了后续访谈，以进一步探讨实施 PC-QIs 的障碍和促进因素。访谈内容根据并使用实施研究综合框架进行分析。
来自加拿大所有 13 个省/地区的 33 个区域医疗保健组织参加了调查。只有 26 个 PC-QIs 中有 5 个被认为对 75%的组织具有高度可行性，包括：护理协调、沟通、报告绩效的结构、让患者和护理人员参与以及整体体验。10 个系统级组织和 11 个初级保健组织/诊所的代表性样本参加了访谈。确定的主要障碍包括：质量改进的资源和人员能力、对 COVID-19 的关注转移以及医疗服务提供者的积极性。促进因素包括：优先考虑 PCC 测量、领导力和拥护者参与、与正在进行的省级战略方向和测量工作保持一致，以及使用技术进行数据收集、管理和报告。
尽管有很高的兴趣和政策一致性，但要有效地使用 PC-QI“准备情况”仍然是一个挑战。需要支持组织收集、使用和报告 PCC 数据，以做出对患者重要的必要改进。
