长期护理院 COVID-19 大流行准备的质量改进协作方法：一项混合方法实施研究。

Quality improvement collaborative approach to COVID-19 pandemic preparedness in long-term care homes: a mixed-methods implementation study.

机构信息

Long-Term Care and Assisted Living, Fraser Health Authority, Surrey, British Columbia, Canada

Long-Term Care and Assisted Living, Fraser Health Authority, Surrey, British Columbia, Canada.

出版信息

BMJ Open Qual. 2024 Apr 8;13(2):e002589. doi: 10.1136/bmjoq-2023-002589.

DOI:10.1136/bmjoq-2023-002589

PMID:38589056

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11015329/

Abstract

BACKGROUND

The devastating impact of the COVID-19 pandemic on long-term care (LTC) homes underscores the importance of effective pandemic preparedness and response. This mixed-methods, implementation science study investigated how a virtual-based quality improvement (QI) collaborative approach can improve uptake of pandemic-related promising practices and shared learning across six LTC homes in British Columbia, Canada in 2021 during the COVID-19 pandemic health emergency.

METHODS

QI teams consisting of residents, family/informal caregivers, care providers and leadership in LTC homes are supported by QI facilitation and shared learning through virtual communication platforms. QI projects address gaps in outbreak preparation, prevention and response; planning for care; staffing; and family presence. Thematically analysed semi-structured qualitative interviews and a validated questionnaire on organisational readiness investigated participants' perceptions of challenges, success factors and benefits of participating in the virtual QI collaborative approach.

RESULTS

Nine themes were identified through interview analysis, including two related to challenges (ie, making time for QI and hands tied by external forces), four regarding factors for successes (ie, team buy-in, working together as a team, bringing together diverse perspectives and facilitators keep us on track) and three on the benefits of the QI collaborative approach (ie, seeing improvements, staff empowerment and appetite for change). Continuous QI facilitation and coaching for QI teams was feasible and sustainable virtually via video conferencing (Zoom). The QI team members showed limited engagement on the virtual communication platform (Slack), which was predominantly used by the implementation science team and QI facilitators to coordinate the study and QI projects, respectively.

CONCLUSIONS

The virtual-based QI collaborative approach to pandemic preparedness supported LTC homes to rapidly and successfully form multidisciplinary QI teams, learn about QI methods and conduct timely QI projects to implement promising practice for improved COVID-19 pandemic response.

摘要

背景

COVID-19 大流行对长期护理（LTC）院造成了毁灭性影响，这突显了有效做好大流行防范和应对工作的重要性。本混合方法、实施科学研究调查了在 COVID-19 大流行卫生紧急情况下，2021 年加拿大不列颠哥伦比亚省的 6 家 LTC 院如何通过基于虚拟的质量改进（QI）合作方法提高与大流行相关的有前途的实践和共享学习的采用率。

方法

QI 团队由 LTC 院的居民、家庭/非正式照顾者、护理提供者和领导层组成，通过虚拟沟通平台提供 QI 促进和共享学习。QI 项目针对爆发准备、预防和应对方面的差距；护理计划；人员配备；以及家庭存在问题。通过半结构化定性访谈和经过验证的组织准备度问卷对主题进行分析，调查参与者对参与虚拟 QI 合作方法的挑战、成功因素和益处的看法。

结果

通过访谈分析确定了 9 个主题，其中包括与挑战相关的两个主题（即，为 QI 腾出时间和受到外部力量的束缚），与成功因素相关的四个主题（即，团队认同、作为一个团队共同合作、汇集不同观点以及促进者使我们保持正轨），以及与 QI 合作方法相关的三个主题（即，看到改进、员工赋权和变革意愿）。通过视频会议（Zoom）虚拟地为 QI 团队提供持续的 QI 促进和指导是可行和可持续的。QI 团队成员在虚拟沟通平台（Slack）上的参与度有限，该平台主要由实施科学团队和 QI 促进者用于协调研究和 QI 项目。