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如何开展患者体验调查并利用调查结果改进服务:澳大利亚全科医疗的定性专家咨询研究

How to implement patient experience surveys and use their findings for service improvement: a qualitative expert consultation study in Australian general practice.

作者信息

Song Hyun Jung, Dennis Sarah, Levesque Jean-Frédéric, Harris Mark

机构信息

Centre for Primary Health Care and Equity, University of New South Wales, Kensington, New South Wales, Australia.

Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.

出版信息

Integr Healthc J. 2020 Nov 1;2(1):e000033. doi: 10.1136/ihj-2019-000033. eCollection 2020.

Abstract

OBJECTIVE

To identify barriers (patient, provider, practice and system levels) to consider when implementing patient experience surveys in Australian general practice and enablers of their systematic use to inform service improvement in clinical practice as well as the broader health system.

METHODS AND ANALYSIS

An expert consultation and qualitative content analysis of cross-sectional, open-text survey data. Data were collected from key international and Australian experts in the areas of measurement and quality improvement in general practice.

RESULTS

Responses from 20 participants from six countries were included in the study. Participants discussed the importance of ensuring value and relevance of surveys to stakeholders. Lack of resources, IT infrastructure, capacity building and sustained funding were identified as barriers to implementing surveys. Participants discussed the importance of clearly defining and communicating the purpose of surveys and agreed on the value of using patient experience to inform reflective, team-based learning at the practice level. Opinions differed on the use of patient experience data at the system level, with some questioning its utility or fairness for external performance reporting. Others recommended the aggregation and reporting of these data under certain conditions, including for the purpose of triangulation with other quality and outcome data. The study identified an evidence gap in the assessment and interpretation of patient experience data at the practice and system levels, including the analysis and contextualisation of survey findings at the system level.

CONCLUSION

Patient experience surveys have potential for guiding practice level quality improvement, but many barriers to their implementation remain. There is need for greater research and policy efforts to understand how this information can be used at the system level for improving Australian general practice.

摘要

目的

确定在澳大利亚全科医疗中实施患者体验调查时需要考虑的障碍(患者、提供者、机构和系统层面),以及系统使用这些调查结果以促进临床实践和更广泛卫生系统服务改进的推动因素。

方法与分析

对横断面开放式调查数据进行专家咨询和定性内容分析。数据收集自全科医疗测量与质量改进领域的关键国际和澳大利亚专家。

结果

研究纳入了来自六个国家的20名参与者的回复。参与者讨论了确保调查对利益相关者具有价值和相关性的重要性。缺乏资源、信息技术基础设施、能力建设和持续资金被确定为实施调查的障碍。参与者讨论了明确界定和传达调查目的的重要性,并认同利用患者体验促进机构层面基于团队的反思性学习的价值。对于在系统层面使用患者体验数据,意见存在分歧,一些人质疑其在外部绩效报告中的效用或公平性。其他人建议在某些条件下汇总和报告这些数据,包括用于与其他质量和结果数据进行三角测量的目的。该研究发现,在机构和系统层面评估和解释患者体验数据方面存在证据空白,包括在系统层面分析调查结果并将其置于背景中。

结论

患者体验调查有潜力指导机构层面的质量改进,但实施过程中仍存在许多障碍。需要加大研究和政策力度,以了解如何在系统层面利用这些信息来改善澳大利亚的全科医疗。

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