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“我们在这里做的事情、我们是谁以及我们提供的服务有了不同的意义”:不列颠哥伦比亚省惩教设施医疗服务治理变革对提供者产生的影响。

"A different sense of what we do here, who we are and what we deliver": Provider perspectives on the effects of a change in governance of healthcare services in correctional facilities in British Columbia.

机构信息

School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada.

BC Centre for Disease Control, Vancouver, BC, Canada.

出版信息

Health Serv Manage Res. 2024 Nov;37(4):219-226. doi: 10.1177/09514848231218626. Epub 2023 Nov 29.

DOI:10.1177/09514848231218626
PMID:38018489
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11545118/
Abstract

In 2017, British Columbia (BC) transferred responsibility for healthcare services in provincial correctional facilities from the Ministry of Public Safety and Solicitor General to the Ministry of Health. This study explored how healthcare leadership perceived the impact of the transfer on services, work-life, and job satisfaction. We conducted one-on-one interviews ( = 8) with healthcare managers and medical and administrative leadership within Correctional Health Services. Using the Two-Factor theory of job satisfaction as a framework, we applied Interpretive Description methodology to analyse interview data. Participants identified changes to four areas of the working environment: (1) staffing, equipment, and resources (2) systems of supervision and support (3) standards, policies, and quality improvement and (4) culture and orientation. These changes predominantly affected motivational factors of job satisfaction and were described as enriching the roles of managers and staff. Participants described improved autonomy and recognition of providers, increased quality of services delivered, and a shift toward patient-centred care. The perspectives of healthcare leaders provide new insight into the potential impact of transferring healthcare services in custody to a public healthcare system. Discussion of changes and their affects also provide practical learning for jurisdictions seeking to improve healthcare under a variety of governance and service-delivery models.

摘要

2017 年,不列颠哥伦比亚省(BC)将省级惩教设施医疗服务的责任从公共安全和检察长部转移到卫生部。本研究探讨了医疗保健领导层如何看待此次转移对服务、工作生活和工作满意度的影响。我们对惩教卫生局的医疗保健经理和医疗及行政领导进行了一对一的访谈(=8)。我们采用工作满意度双因素理论作为框架,应用解释性描述方法分析访谈数据。参与者确定了工作环境四个方面的变化:(1)人员配置、设备和资源;(2)监督和支持系统;(3)标准、政策和质量改进;(4)文化和定位。这些变化主要影响了工作满意度的激励因素,被描述为丰富了管理人员和工作人员的角色。参与者描述了提供者自主权和认可的提高、服务质量的提高,以及向以患者为中心的护理的转变。医疗保健领导者的观点为在公共医疗体系中转移监管医疗服务的潜在影响提供了新的见解。对变化及其影响的讨论也为寻求在各种治理和服务提供模式下改善医疗保健的司法管辖区提供了实际的学习经验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9afa/11545118/918341877309/10.1177_09514848231218626-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9afa/11545118/918341877309/10.1177_09514848231218626-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9afa/11545118/918341877309/10.1177_09514848231218626-fig1.jpg

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