Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
Stockholm Health Care Services, Academic Primary Healthcare Centre, Stockholm, Sweden.
BMJ Open. 2024 Aug 5;14(8):e089224. doi: 10.1136/bmjopen-2024-089224.
To codesign safety-netting strategies for primary and emergency care settings by integrating the experiences and ideas of patients, carers and clinicians.
A codesign process involving two focus group discussions, eight individual interviews and five workshops. All sessions were audio recorded and transcribed verbatim. Data were analysed using qualitative content analysis and reported using the Consolidated criteria for Reporting Qualitative research guidelines.
Primary and emergency care in Sweden, focusing on the Stockholm region.
7 (5 women) individuals with patient expertise, 1 (man) individual with carer expertise, 18 (12 women) individuals with clinical expertise.
Three main categories reflecting strategies for applying safety-netting were developed: first, , which involves understanding patient concerns, tailoring communication and using appropriate modalities for communicating; second, which involves summarising information, asking a teach-back question and anticipating questions post consultation; and third, which involves facilitating reconsultation, helping patients and carers to navigate the health system and explaining the care context and its purpose.
Our study highlights the collaborative nature of safety-netting, engaging both the clinician and patient, sometimes supported by carers, in an iterative process. Adding to previous research, our study also emphasises the importance of anticipating postconsultation inquiries and facilitating reconsultation.
通过整合患者、护理人员和临床医生的经验和想法,为初级保健和急诊环境制定安全网策略。
一个涉及两个焦点小组讨论、八个个人访谈和五个研讨会的共同设计过程。所有会议都进行了录音,并逐字转录。使用定性内容分析对数据进行分析,并按照《定性研究报告的统一标准》报告。
瑞典的初级保健和急诊,重点是斯德哥尔摩地区。
7 名(5 名女性)具有患者专业知识的个人,1 名(男性)具有护理人员专业知识的个人,18 名(12 名女性)具有临床专业知识的个人。
制定了三个反映安全网应用策略的主要类别:首先,“同理心”,包括理解患者的担忧、量身定制沟通方式并使用适当的沟通方式;其次,“总结信息”,包括总结信息、询问回授问题并预测咨询后可能会提出的问题;最后,“促进再咨询”,包括帮助患者和护理人员了解医疗体系、解释护理环境及其目的。
我们的研究强调了安全网的协作性质,使临床医生和患者共同参与一个迭代过程,有时还得到护理人员的支持。除了之前的研究,我们的研究还强调了预测咨询后的询问和促进再咨询的重要性。