Eldh Ann Catrine, Hälleberg-Nyman Maria, Joelsson-Alm Eva, Wallin Lars
Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Front Health Serv. 2023 Apr 17;3:1112936. doi: 10.3389/frhs.2023.1112936. eCollection 2023.
Numerous endeavours to ensure that day-to-day healthcare is both evidence-based and person-centred have generated extensive, although partial, comprehension of what guarantees quality improvement. To address quality issues, researchers and clinicians have developed several strategies as well as implementation theories, models, and frameworks. However, more progress is needed regarding how to facilitate guideline and policy implementation that guarantees effective changes take place in a timely and safe manner. This paper considers experiences of engaging and supporting local facilitators in knowledge implementation. Drawing on several interventions, considering both training and support, this general commentary discusses whom to engage and the length, content, quantity, and type of support along with expected outcomes of facilitators' activities. In addition, this paper suggests that patient facilitators could help produce evidence-based and person-centred care. We conclude that research about the roles and functions of facilitators needs to include more structured follow-ups and also improvement projects. This can increase the speed of learning with respect to what works, for whom, in what context, why (or why not), and with what outcomes when it comes to facilitator support and tasks.
为确保日常医疗保健既基于证据又以患者为中心，人们进行了诸多努力，这使得人们对保证质量提升的因素有了广泛但仍不全面的理解。为解决质量问题，研究人员和临床医生开发了多种策略以及实施理论、模型和框架。然而，在如何促进指南和政策的实施以确保有效变革及时、安全地发生方面，仍需取得更多进展。本文探讨了在知识实施过程中吸引和支持当地促进者的经验。基于多种干预措施，综合考虑培训和支持，这篇一般性评论讨论了应吸引哪些人、支持的时长、内容、数量和类型，以及促进者活动的预期成果。此外，本文认为患者促进者有助于提供基于证据且以患者为中心的护理。我们得出结论，关于促进者的角色和功能的研究需要包括更具结构性的后续跟进以及改进项目。这可以加快对以下方面的学习速度：在促进者支持和任务方面，什么有效、对谁有效、在何种背景下有效、为何有效（或为何无效）以及会产生什么结果。
