Thomas Kristin, Dannapfel Petra
Division of Society and Health, Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health, Linköping University, Linköping, Sweden.
Region Östergötland, Linköping, Sweden.
Front Health Serv. 2022 Nov 24;2:958659. doi: 10.3389/frhs.2022.958659. eCollection 2022.
The demographic change of an aging population constitutes a challenge for primary care organizations worldwide. The systematic implementation of preventative and proactive care models is needed to cope with increased care demands.
To investigate the organizational readiness in primary care to implement a new care model to prevent hospitalization among frail older adults.
Individual qualitative interviews with health care staff investigated organizational readiness at seven primary care units in Sweden. A semi-structured interview guide was used during the interviews and included broad questions on individual and collective readiness to change. Directed content analysis and organizational readiness to change theory were used in data analysis.
Positive beliefs among staff such as perceived benefits and compatibility with existing values contributed to a strong commitment to implement the new care model. However, perceptions such as unclear task demands, limited resources and concerns about new collaborative structures challenged implementation.
The findings emphasize implementation as an inter-organizational phenomenon, especially for holistic practices that span across multiple health care providers and disciplines. Furthermore, implementing care models in healthcare may require a change of culture as much as a change of practice.
人口老龄化的人口结构变化给全球基层医疗组织带来了挑战。需要系统地实施预防和主动护理模式来应对不断增加的护理需求。
调查基层医疗中实施新护理模式以预防体弱老年人住院的组织准备情况。
对瑞典七个基层医疗单位的医护人员进行个人定性访谈，以调查组织准备情况。访谈期间使用了半结构化访谈指南，其中包括关于个人和集体变革准备情况的广泛问题。数据分析采用定向内容分析和组织变革准备理论。
工作人员的积极信念，如感知到的益处以及与现有价值观的兼容性，有助于坚定实施新护理模式的决心。然而，诸如任务要求不明确、资源有限以及对新协作结构的担忧等看法对实施构成了挑战。
研究结果强调实施是一种组织间现象，特别是对于跨越多个医疗服务提供者和学科的整体实践而言。此外，在医疗保健中实施护理模式可能既需要改变文化，也需要改变实践。
