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以不同方式开展基层医疗合作:探索边界与边界对象。

Approaching collaboration in primary care differently: Exploring boundaries and boundary objects.

作者信息

Walsh Monique

机构信息

University of British Columbia, Kelowna, British Columbia, Canada.

出版信息

Healthc Manage Forum. 2025 Jan;38(1):58-64. doi: 10.1177/08404704241271150. Epub 2024 Aug 13.

Abstract

In recent primary care policy, collaboration is often understood as an outcome, such as the delivery of team-based care or an integrated health system. This outcome-based understanding of collaboration in policy has proven challenging to achieve in practice. This article introduces the concepts of constructing boundaries and boundary objects used in other disciplines, to support our understanding of collaboration by observing the collaborative process. Multiple methods, such as semi-structured interviews, discourse analysis, and member-checking, were used to compare primary care collaborations across three distinct time periods during the onset of COVID-19 within Interior British Columbia. Data analysis revealed the changing nature of boundaries and boundary objects, providing insights into the collaborative process. Through the exploration of boundaries and boundary objects, this article provides a way to approach collaboration in practice differently. By better understanding the process of collaboration, this research could potentially improve collaborative outcomes.

摘要

在近期的基层医疗政策中,协作通常被理解为一种结果,例如提供团队式医疗服务或一个整合的卫生系统。事实证明,政策中这种基于结果的协作理解在实践中难以实现。本文引入了其他学科中使用的构建边界和边界对象的概念,通过观察协作过程来支持我们对协作的理解。我们采用了多种方法,如半结构化访谈、话语分析和成员核对,来比较不列颠哥伦比亚省内陆地区在新冠疫情初期三个不同时间段的基层医疗协作情况。数据分析揭示了边界和边界对象的变化性质,为协作过程提供了见解。通过对边界和边界对象的探索,本文提供了一种在实践中以不同方式处理协作的方法。通过更好地理解协作过程,这项研究可能会改善协作成果。

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The Quadruple Aim: care, health, cost and meaning in work.四重目标:医疗护理、健康、成本及工作意义。
BMJ Qual Saf. 2015 Oct;24(10):608-10. doi: 10.1136/bmjqs-2015-004160. Epub 2015 Jun 2.
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