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方案:如何通过数字护理导航流程支持有社会护理需求的人获得远程初级护理?英国全科医疗中以远程护理为“新常态”的多地点案例研究。

Protocol: How can people with social care needs be supported through processes of digital care navigation to access remote primary care? A multi-site case study in UK general practice of remote care as the 'new normal'.

作者信息

Hughes Gemma, Rybczynska-Bunt Sarah, Shasha'h Sara, Greene Sarah, Shaw Sara, Greenhalgh Trisha

机构信息

Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK.

Penisula Medical School (Faculty of Health), University of Plymouth, Plymouth, PL6 8BX, UK.

出版信息

NIHR Open Res. 2023 Apr 5;3:17. doi: 10.3310/nihropenres.13385.1. eCollection 2023.

Abstract

BACKGROUND

Care navigation refers to support for patients accessing primary care and other related services. The expansion of digitally enabled care in the UK since the coronavirus disease 2019 (COVID-19) pandemic has led to a greater need for care navigation: supporting people to access primary care digitally and, if necessary, to help them find alternative non-digital routes of access. Support to patients with social care needs (including but not limited to those who are homeless and insecurely housed, living in residential care and supported by domiciliary carers) increasingly involves work to navigate primary care provided remotely and accessed digitally. There is little knowledge about how this work is being done.

METHODS

involves embedded researchers identifying digital care navigation for patients accessing services in 11 GP practices recruited to a linked study of remote primary care ( ). Digital care navigation will be studied through go-along (in-person or remote) interviews with a sample of 20 people offering formal (paid or voluntary) support, 6 national and regional stakeholders who plan, commission or provide digital care navigation and a focus group with 12 social prescribers engaged in digital care navigation. A co-design workshop with people working in, or commissioning, social care settings will consider how findings can inform improved digital care navigation, for example through the development of resources or guidance for care navigators.

RESULTS ANTICIPATED

Findings are anticipated to include evidence of how digital care navigation is practised, the work that is done to support patients in accessing remote primary care, and how this work is shaped by material resources and variations in the configuration of services and infrastructure.

CONCLUSIONS

New explanations of the work needed to navigate digital care will inform policy and service developments aimed at helping patients benefit from remote primary care.

摘要

背景

护理导航是指为患者获取初级保健及其他相关服务提供支持。自2019年冠状病毒病(COVID-19)大流行以来,英国数字化护理的扩展导致对护理导航的需求更大:支持人们以数字化方式获取初级保健,并在必要时帮助他们找到其他非数字化的获取途径。对有社会护理需求的患者(包括但不限于无家可归和住房不安全者、住在养老院并由居家护理人员提供支持的人)的支持越来越多地涉及引导他们获取远程提供并通过数字化方式访问的初级保健的工作。对于这项工作的开展方式知之甚少。

方法

研究包括嵌入式研究人员在参与远程初级保健关联研究的11家全科医生诊所中,识别为获取服务的患者提供的数字化护理导航。将通过与20名提供正式(有偿或志愿)支持的人员、6名规划、委托或提供数字化护理导航的国家和地区利益相关者进行陪同(面对面或远程)访谈,以及与12名参与数字化护理导航的社会处方医生进行焦点小组讨论,来研究数字化护理导航。与在社会护理环境中工作或委托开展工作的人员共同设计的研讨会将考虑研究结果如何为改进数字化护理导航提供信息,例如通过开发护理导航员资源或指南。

预期结果

预计研究结果将包括数字化护理导航的实践证据、为支持患者获取远程初级保健所做的工作,以及这项工作如何受到物质资源以及服务和基础设施配置差异的影响。

结论

关于数字化护理导航所需工作的新解释将为旨在帮助患者从远程初级保健中受益的政策和服务发展提供信息。

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