Ellis Louise A, Fisher Georgia, Churruca Kate, Saba Maree, Schroeder Tanja, Mahadeva Janani, Vagholkar Sanjyot, Lee Mark Yang, Harrison Reema, Willcock Simon, Braithwaite Jeffrey
Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
MQ Health, Macquarie University, Sydney, Australia.
Int J Health Plann Manage. 2025 Mar;40(2):368-380. doi: 10.1002/hpm.3880. Epub 2024 Dec 9.
Though an important component of high-quality healthcare, the routine collection of patient experience data is limited in primary care, as is the evidence for how this data is being used for quality improvement. This study used a learning health system (LHS) framework to describe how a university-affiliated community general practice is integrating patient experience data into service and quality improvement efforts, and to identify barriers and facilitators.
A co-designed qualitative case study was conducted with academic researchers and staff from a university-affiliated general practice in Australia. Semi-structured interviews were conducted in April 2024 with practice staff, and transcripts were deductively coded according to a five-domain learning health systems framework, and with additional codes capturing barriers and facilitators.
Eighteen (53%) practice staff were interviewed, including general practitioners (n = 11), a practice nurse (n = 1), and administrative staff (n = 6). Participants identified multiple methods through which the practice captured the patient experience that spanned all domains of the LHS framework. However, there was less evidence of a coherent quality improvement strategy being employed, with associated barriers identified around staff workloads, training, and existing government funding policies. Key facilitators to the use of patient experience data included: membership of a larger health organisation and university; key dedicated administrative and clinical roles; and effective leadership, governance structures and policies to support continuous learning and drive service improvement.
This study presents a case example of how patient experience data is being integrated into general practice and identifies key barriers and facilitators to initiating and translating this data for continuous healthcare improvement. By mapping the use of patient experience data to a LHS framework, this study shows how LHS principles can be applied to primary care to facilitate the capture and use of patient experience data on an ongoing basis.
尽管患者体验数据的常规收集是高质量医疗保健的重要组成部分,但在初级保健中,此类数据的常规收集工作有限,而且关于如何将这些数据用于质量改进的证据也很有限。本研究采用学习型健康系统(LHS)框架来描述一所大学附属社区全科诊所如何将患者体验数据整合到服务和质量改进工作中,并识别其中的障碍和促进因素。
与澳大利亚一所大学附属全科诊所的学术研究人员和工作人员共同开展了一项定性案例研究。2024年4月对诊所工作人员进行了半结构化访谈,并根据一个五领域学习型健康系统框架对访谈记录进行了演绎编码,同时还增加了捕捉障碍和促进因素的编码。
共访谈了18名(53%)诊所工作人员,包括全科医生(n = 11)、一名执业护士(n = 1)和行政人员(n = 6)。参与者确定了该诊所收集患者体验的多种方法,这些方法涵盖了LHS框架的所有领域。然而,采用连贯质量改进策略的证据较少,同时发现了围绕员工工作量、培训和现有政府资助政策的相关障碍。使用患者体验数据的关键促进因素包括:隶属于一个更大的卫生组织和大学;关键的专职行政和临床角色;以及有效的领导、治理结构和政策,以支持持续学习并推动服务改进。
本研究展示了一个将患者体验数据整合到全科医疗中的案例,并确定了启动和转化这些数据以持续改善医疗保健的关键障碍和促进因素。通过将患者体验数据的使用映射到LHS框架,本研究展示了LHS原则如何应用于初级保健,以促进持续收集和使用患者体验数据。