Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
Research Centre for Autonomy and Participation of Persons with a Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands.
Health Expect. 2023 Feb;26(1):132-145. doi: 10.1111/hex.13628. Epub 2022 Nov 8.
In 24/7 disability care facilities, patient-reported experience measures (PREMs) are important to help healthcare professionals understand what matters to care users and to improve the quality of care. However, the successful implementation of a PREM is complex. In a Dutch disability care organization, stakeholders cocreated tailored implementation strategies aimed at improving the use and integration of a qualitative PREM. This study gives insights into the uptake and experiences with these cocreated implementation strategies and the perceived impact of the set of strategies.
We performed a prospective process evaluation between February 2020 and February 2021. We collected data in three disability care facilities from 35 care users, 11 professionals, 3 facility managers and 4 organization representatives. Data collection included observations during kick-offs and learning goal meetings and several attendance checklists. We collected 133 questionnaires (Time 0 and Time 1). We conducted 35 individual semistructured interviews and an online focus group interview. Quantitative data were analysed using descriptive statistics and qualitative data using directed content analysis.
The exposure to and adoption of strategies was between 76% and 100%. Participants were positive about tailoring the strategies to each facility. Implementation was hindered by challenges in care users' communication and COVID-19. The perceived impact referred to an improved understanding of the goal and added value of the PREM and better preparation and execution of the PREM. The impact of the set of strategies was mainly experienced on the micro level.
The uptake of the cocreated implementation strategies was acceptable. The participants valued the tailored approach, which enabled them to focus on facility-specific learning goals. Stakeholder engagement and co-created strategies may have strengthened the adoption of and experiences with the implementation.
In this article, we present the process evaluation of implementation strategies for the integrated use of a PREM in disability care. A development group consisting of communication vulnerable care users, trainers and professionals developed the implementation strategies. The disability care organization was responsible for the planning and organization of the implementation process. During the process evaluation the end users, trainers, professionals and managers tailored the implementation strategies to their own settings and needs. Researchers observed this implementation process and interviewed the stakeholders about their experiences and the perceived impact.
在 24/7 残疾护理设施中，患者报告的体验测量（PREMs）对于帮助医疗保健专业人员了解护理使用者关注的问题并提高护理质量非常重要。然而，PREM 的成功实施是复杂的。在荷兰的一家残疾护理组织中，利益相关者共同制定了有针对性的实施策略，旨在提高定性 PREM 的使用和整合。本研究深入了解了这些共同制定的实施策略的采用情况和经验，以及策略集的感知影响。
我们在 2020 年 2 月至 2021 年 2 月期间进行了一项前瞻性过程评估。我们从 35 名护理使用者、11 名专业人员、3 名设施经理和 4 名组织代表在三个残疾护理设施中收集数据。数据收集包括在启动会议和学习目标会议期间的观察以及多次出勤检查表。我们共收集了 133 份问卷（时间 0 和时间 1）。我们进行了 35 次单独的半结构式访谈和一次在线焦点小组访谈。定量数据采用描述性统计分析，定性数据采用有针对性的内容分析。
策略的暴露和采用率在 76%至 100%之间。参与者对针对每个设施进行策略定制持积极态度。实施受到护理使用者沟通和 COVID-19 挑战的阻碍。感知到的影响涉及对 PREM 目标和附加值的更好理解，以及 PREM 的更好准备和执行。策略集的影响主要在微观层面上感受到。
共同制定的实施策略的采用是可以接受的。参与者重视定制方法，这使他们能够专注于特定设施的学习目标。利益相关者的参与和共同制定的策略可能增强了实施策略的采用和经验。
在本文中，我们介绍了残疾护理中 PREM 综合使用的实施策略的过程评估。由沟通能力较弱的护理使用者、培训师和专业人员组成的开发小组制定了实施策略。残疾护理组织负责实施过程的规划和组织。在过程评估中，最终用户、培训师、专业人员和管理人员根据自己的环境和需求调整实施策略。研究人员观察了这一实施过程，并采访了利益相关者，了解他们的经验和感知到的影响。
