Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
Primary Care Group 'Dokter Drenthe' (formerly known as Huisartsenzorg Drenthe; HZD), Assen, The Netherlands.
Scand J Prim Health Care. 2023 Dec;41(4):377-391. doi: 10.1080/02813432.2023.2250392. Epub 2023 Sep 4.
The TARGET program for integrated, person-centered care for people with chronic conditions offers primary care (PC) professionals a set of tools and trainings to actively engage in population segmentation and person-centered needs assessments (PCNAs). A pilot study was conducted to gain insight into the program's feasibility and acceptability, and identify preconditions for successful implementation.
Seven Dutch PC practices participated in a half-year pilot study starting in August 2020. We performed a review of the population segmentation tool, observed four training sessions and 15 PCNAs, and interviewed 15 professionals and 12 patients.
Regarding feasibility and acceptability, we found that the tools and trainings provided professionals with skills to use the segmentation tool and take a more coaching role in the well-appreciated PCNAs. Concerning implementation preconditions, we found that team commitment and network connections need improvement, although work pleasure increased and professionals generally wanted the program to continue.
While the content of the TARGET program is supported by its users, the implementation process, for instance team commitment to the program, needs more attention in future upscaling efforts.
TARGET 项目提供了一套综合性的、以患者为中心的慢性病管理工具和培训，旨在帮助初级保健（PC）专业人员积极参与人群细分和以患者为中心的需求评估（PCNA）。本研究开展了一项试点研究，以深入了解该项目的可行性和可接受性，并确定成功实施的前提条件。
2020 年 8 月开始，7 家荷兰初级保健诊所参与了为期半年的试点研究。我们对人群细分工具进行了审查，观察了 4 次培训课程和 15 次 PCNA，并对 15 名专业人员和 12 名患者进行了访谈。
在可行性和可接受性方面，我们发现这些工具和培训使专业人员具备了使用细分工具和在备受赞赏的 PCNA 中发挥更具指导作用的技能。在实施前提条件方面，我们发现团队承诺和网络联系需要改进，尽管工作满意度有所提高，且专业人员普遍希望该项目继续进行。
尽管 TARGET 项目的内容得到了用户的支持，但在未来的推广工作中，需要更加关注实施过程，例如团队对项目的承诺。
