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医疗保健机构可以采取哪些措施来提高医疗参与度?一项系统综述。

What can healthcare organisations do to improve medical engagement? A systematic review.

作者信息

Perry Jen

机构信息

North London Mental Health Partnership, London, UK

出版信息

BMJ Lead. 2024 Aug 21. doi: 10.1136/leader-2023-000963.

DOI:10.1136/leader-2023-000963
PMID:39168607
Abstract

BACKGROUND

Medical engagement is linked to improved outcomes for staff and patients including a reduction in staff turnover. There are significant problems with recruitment and retention of doctors globally, it is, therefore, important to try to increase medical engagement within healthcare organisations. This systematic review aimed to review evidence from 2018 to 2023 from peer-reviewed journals on interventions to improve medical engagement and from this generate practical recommendations for healthcare organisations.

METHOD

A search strategy was developed and used across six databases alongside citation searching. Articles were screened to check whether they met the study criteria and were then critically appraised. The interventions were extracted and a thematic analysis, using an inductive approach, was undertaken.

RESULTS

15 articles were found to have met the criteria, however, the studies were generally found to be of low-quality research evidence. The interventions from the articles were grouped into nine themes covering topics such as 'Improvements to working conditions', 'Increasing support to doctors' and 'Rewards/incentives/recognition'.

CONCLUSION

The review generated a wide range of interventions which could be used to improve medical engagement, however, critical appraisal revealed that they were of low-quality evidence, so their effectiveness should be interpreted with some caution. The majority of the interventions were transferable to healthcare settings, with some limitations depending on the country. Several HR models were described as options for implementing these interventions within healthcare organisations. Further high-quality research is needed in this area.

摘要

背景

医务人员的参与度与员工和患者的更好结局相关,包括降低员工流失率。全球范围内,医生的招聘和留用存在重大问题,因此,努力提高医疗机构中医务人员的参与度非常重要。本系统综述旨在回顾2018年至2023年同行评审期刊中关于提高医务人员参与度干预措施的证据,并据此为医疗机构提出实用建议。

方法

制定了检索策略,并在六个数据库以及引文检索中使用。对文章进行筛选,以检查它们是否符合研究标准,然后进行严格评估。提取干预措施,并采用归纳法进行主题分析。

结果

发现有15篇文章符合标准,然而,这些研究总体上被认为是低质量的研究证据。文章中的干预措施分为九个主题,涵盖“工作条件改善”、“增加对医生的支持”和“奖励/激励/认可”等主题。

结论

该综述产生了一系列可用于提高医务人员参与度的干预措施,然而,严格评估表明它们的证据质量较低,因此其有效性的解释应谨慎。大多数干预措施可转移到医疗环境中,但因国家而异存在一些限制。描述了几种人力资源模式作为在医疗机构内实施这些干预措施的选择。该领域需要进一步的高质量研究。

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