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健康之轮诊所:从医疗服务提供者的角度出发,一个改善医疗服务可及性的第一民族社区伙伴关系护理模式。

Wellness Wheel Clinics: A First Nation community-partnered care model improving healthcare access, from healthcare providers' perspectives.

机构信息

Research Department, Saskatchewan Health Authority, Regina, Saskatchewan, Canada.

Department of Academic Family Medicine, University of Saskatchewan College of Medicine, Regina, Saskatchewan, Canada.

出版信息

Health Promot Int. 2023 Aug 1;38(4). doi: 10.1093/heapro/daad079.

Abstract

First Nation people residing in rural and remote communities have limited primary healthcare access, which often affects chronic disease management leading to poor health outcomes. Individuals with lived experiences of chronic disease and substance use, along with health directors, advocated for improved services. Subsequently, an urban healthcare team in partnership with four First Nation communities developed an Outreach clinic to address healthcare access barriers. Established in 2016, this community-led clinic improves primary care access and chronic disease management in First Nation communities. Employing a qualitative research design, interviews were conducted with 15 clinic providers and 9 community members to explore the clinic's 1-year post-implementation impacts. Thematic data analysis indicated that engagement and approval by community leadership, support from Elders and community members and collaboration with existing community healthcare staff were crucial for establishing the Outreach clinic. Initial logistical challenges with space allocation, equipment, medical supplies, funding, staffing, medical records and appointment scheduling were resolved through community consultation and creative solutions. A nurse coordinator ensured continuity of care and was integral to ensuring clients receive seamless care. The commitment of the outreach team and the collective goal of providing client-centered care were instrumental in the clinic's success. In partnership with communities, access to healthcare in First Nation communities can be enhanced by coordinating Outreach clinics through existing community healthcare facilities.

摘要

居住在农村和偏远社区的第一民族居民获得基本医疗保健的机会有限,这往往会影响慢性病的管理,导致健康状况不佳。有慢性病和药物使用经历的个人以及卫生主管人员倡导改善服务。随后,一个城市医疗保健团队与四个第一民族社区合作,成立了一个外展诊所,以解决医疗保健获取方面的障碍。该诊所成立于 2016 年,改善了第一民族社区的基本医疗保健和慢性病管理。该研究采用定性研究设计,对 15 名诊所提供者和 9 名社区成员进行了访谈,以探讨诊所实施 1 年后的影响。主题数据分析表明,社区领导层的参与和认可、长老和社区成员的支持以及与现有社区医疗保健工作人员的合作,对建立外展诊所至关重要。最初在空间分配、设备、医疗用品、资金、人员配备、医疗记录和预约安排方面存在后勤方面的挑战,通过社区协商和创造性的解决方案得到了解决。一名护士协调员确保了护理的连续性,是确保患者获得无缝护理的关键。外展团队的承诺和提供以患者为中心的护理的共同目标,对诊所的成功起到了重要作用。通过与社区合作,通过现有社区医疗设施协调外展诊所,可以改善第一民族社区的医疗保健获取。

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