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基层医疗中 2 型糖尿病管理的质量优先事项:COMPAS + 质量改进合作的结果。

Quality priorities related to the management of type 2 diabetes in primary care: results from the COMPAS + quality improvement collaborative.

机构信息

School of Rehabilitation, Faculty of Medicine, Université de Montréal, CP 6128 Succursale Centre-Ville, Montreal, QC, H3C 3J7, Canada.

Department of Family Emergency Medicine, Faculty of Medicine and Health Sciences, Centre de recherche Charles-LeMoyne (CR-CRCLM), Université de Sherbrooke - Campus de Longueuil, Longueuil, QC, Canada.

出版信息

BMC Prim Care. 2024 Nov 16;25(1):397. doi: 10.1186/s12875-024-02641-9.

Abstract

BACKGROUND

This study aims to describe the main type 2 diabetes mellitus (T2DM) quality improvement (QI) challenges identified by primary care teams in the province of Quebec who participated in the COMPAS + QI collaborative.

METHODS

A qualitative descriptive design was used to analyse the results of 8 COMPAS + workshops conducted in 4 regions of the province between 2016 and 2020. Deductive content analysis was performed to classify the reported QI priorities under the Consolidated Framework for Implementation Research domains; and proposed change strategies under the Behavior Change Wheel (BCW) intervention functions.

RESULTS

A total of 177 participants attended the T2DM COMPAS + workshops. Three QI priorities were identified: (1) lack of coordination and integration of T2DM care and services; (2) lack of preventive services for pre-diabetes and T2DM; and (3) lack of integration of the patients-as-partners approach to support T2DM self-management. The proposed QI strategies to address those priorities were classified under the education, training, persuasion, habilitation and restructuring BCW intervention functions.

CONCLUSION

This study provides insights on how QI collaboratives can support the identification of QI priorities and strategies to improve T2DM management in primary care.

摘要

背景

本研究旨在描述参与 COMPAS + QI 合作的魁北克省基层医疗团队在 2 型糖尿病 (T2DM) 质量改进 (QI) 方面遇到的主要挑战。

方法

采用定性描述设计,对 2016 年至 2020 年间在该省 4 个地区举办的 8 次 COMPAS + 研讨会的结果进行分析。采用演绎内容分析法,将报告的 QI 重点归入实施研究综合框架领域;并根据行为改变轮 (BCW) 干预功能,提出改变策略。

结果

共有 177 名参与者参加了 T2DM COMPAS + 研讨会。确定了三个 QI 重点:(1) T2DM 护理和服务缺乏协调和整合;(2) 对糖尿病前期和 T2DM 的预防服务不足;(3) 缺乏患者作为合作伙伴的方法来支持 T2DM 自我管理。为解决这些重点问题而提出的 QI 策略被归入 BCW 的教育、培训、劝说、赋权和重构干预功能。

结论

本研究提供了有关 QI 合作如何能够支持确定 QI 重点和策略以改善初级保健中 T2DM 管理的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dfc/11568624/ea8fa02bd5e8/12875_2024_2641_Fig1_HTML.jpg

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