Institute for Health Transformation, Global Centre for Preventative Health and Nutrition, School of Health and Social Development Faculty of Health, Deakin University, Geelong, Australia.
Deakin Rural Health, School of Medicine, Faculty of Health, Deakin University, Geelong, Australia.
PLoS One. 2023 Sep 8;18(9):e0290386. doi: 10.1371/journal.pone.0290386. eCollection 2023.
World-wide, health service providers are moving towards innovative models of clinical home-based care services as a key strategy to improve equity of access and quality of care. To optimise existing and new clinical home-based care programs, evidence informed approaches are needed that consider the complexity of the health care system across different contexts.
We present a protocol for working with health services and their partners to perform rapid identification, prioritisation, and co-design of content-appropriate strategies to optimise the delivery of healthcare at home for older people in rural and regional areas. The protocol combines Systems Thinking and Implementation Science using a Consensus Mapping and Co-design (CMC) process delivered over five workshops.
The protocol will be implemented with rural and regional healthcare providers to identify digital and non-digital solutions that have the potential to inform models of service delivery, improve patient experience, and optimise health outcomes. The combination of system and implementation science is a unique approach for optimising healthcare at home for older populations, especially in the rural context where need is high. This is the first protocol to integrate the use of systems and implementation science into one process and articulating these methods will help with replicating this in future practice. Results of the design phase will translate into practice through standard health service planning methods to enhance implementation and sustainability. The delivery of the protocol will include building capacity of health service workers to embed the design, implementation, and evaluation approach into normal practice. This protocol forms part of the DELIVER (Delivering Enhanced heaLthcare at home through optImising Virtual tools for oldEr people in Rural and regional Australia) Project. Funded by Australia's Medical Research Future Fund, DELIVER involves a collaboration with public health services of Western Victoria, Australia.
在全球范围内，医疗服务提供者正在转向创新的临床家庭护理服务模式，作为改善获取机会和护理质量公平性的关键策略。为了优化现有的和新的临床家庭护理计划，需要采用证据为基础的方法，考虑不同背景下医疗保健系统的复杂性。
我们提出了一个与卫生服务及其合作伙伴合作的方案，以快速确定、优先考虑和共同设计内容适当的策略，优化农村和偏远地区老年人的家庭医疗保健服务。该方案结合了系统思维和实施科学，使用共识映射和共同设计（CMC）过程在五个研讨会上进行。
该方案将与农村和偏远地区的医疗保健提供者一起实施，以确定具有潜在潜力的数字和非数字解决方案，这些解决方案可以为服务提供模式提供信息，改善患者体验，并优化健康结果。系统科学和实施科学的结合是优化老年人群体家庭医疗保健的独特方法，特别是在需求较高的农村环境中。这是第一个将系统和实施科学结合到一个过程中的方案，并阐明这些方法将有助于在未来的实践中复制这一方法。设计阶段的结果将通过标准的卫生服务规划方法转化为实践，以增强实施和可持续性。该方案的实施将包括增强卫生服务工作者的能力，将设计、实施和评估方法嵌入到正常实践中。该方案是 DELIVER（通过优化虚拟工具为澳大利亚农村和偏远地区的老年人提供增强的家庭医疗保健）项目的一部分。该项目由澳大利亚医学研究未来基金资助，涉及与澳大利亚维多利亚州西部的公共卫生服务部门合作。
