Norway Department of Industrial Economics and Technology Management, Norwegian University of Science and Technology, Teknologiveien 22, Gjøvik, 2802, Norway.
Innlandet Hospital Trust, Lillehammer, Norway.
BMC Health Serv Res. 2024 Aug 6;24(1):899. doi: 10.1186/s12913-024-11327-y.
Continuous improvement is based on fostering practitioners' suggestions to modify their own work processes This improvement strategy is widely applied in healthcare but difficult to maintain. The cross-disciplinary nature of many care processes constitutes an extra impediment.
The study had an explorative design with a qualitative single-case approach. The case presents a project to improve the treatment of patients with thrombotic stroke. Data was obtained via hands on involvement, documents, observations, and interviews with participants in a cross-functional improvement group. A thematic analysis method was employed.
Through learning how tasks were carried out in other disciplines, the participants developed a common understanding of why it took so long to provide treatment to stroke patients. These insights were used to implement practical changes, leading to immediate improvements in stroke care delivery. The results were fed back so that successes became visible. Participants' understandings of the local context enabled them to convince peers of the rationale of changes, setting in motion a permanent improvement structure. The participants considered that mapping and then assessing the entire workflow across disciplines were relevant methods for improving the quality of patient care.
Starting an improvement project in a cross disciplinary environment requires deep engagement on the part of professionals. A quintessential prerequisite is therefore the realization that the quality of care depends on cross-disciplinary cooperation. A facilitated learning arena needs to (1) create insights into each other's colleagues' tasks and process interdependencies, (2) increase understanding of how the distribution of tasks among specialist units affects the quality of care, and (3) frequently report and provide feedback on results to keep the process going.
持续改进基于培养从业者提出建议以修改自身工作流程。该改进策略在医疗保健领域得到广泛应用，但难以维持。许多护理流程的跨学科性质构成了额外的障碍。
本研究采用探索性设计和定性单案例方法。该案例呈现了一个改进血栓性脑卒中患者治疗的项目。数据通过跨职能改进小组的参与者的实际参与、文件、观察和访谈获得。采用主题分析方法。
通过了解其他学科如何执行任务，参与者共同理解了为什么为脑卒中患者提供治疗需要这么长时间。这些见解被用于实施实际变革，从而立即改善脑卒中护理服务。将结果反馈回来，以便成功可见。参与者对当地情况的了解使他们能够说服同行改变的合理性，从而启动了一个永久性的改进结构。参与者认为，跨学科映射和评估整个工作流程是改进患者护理质量的相关方法。
在跨学科环境中启动改进项目需要专业人员的深度参与。因此，一个至关重要的前提是认识到护理质量取决于跨学科合作。一个促进学习的场所需要（1）深入了解彼此同事的任务和流程相互依存关系，（2）提高对任务在专科单位之间的分配如何影响护理质量的理解，以及（3）经常报告和提供结果反馈，以保持进程。
