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一项旨在提高患者导航员能力的培训项目的实施与评估:中国一家公立三级医院的准实验

Implementation and Evaluation of a Training Program to Improve Patient Navigators' Competencies: A Quasi-Experiment at a Public Tertiary Hospital in China.

作者信息

Liu Shuo, Tang Weiwei, Chang Qing, Lei Jueming, Yue Haitao, Hou Linjie, Morlock Laura

机构信息

Office of Planning and Development, Peking Union Medical College Hospital (Dongdan Campus), No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730, China.

Human Resource Department, Peking Union Medical College Hospital (Dongdan Campus), No.1 Shuaifuyuan Wangfujing Dongcheng District, Beijing 100730, China.

出版信息

Healthcare (Basel). 2025 Feb 11;13(4):387. doi: 10.3390/healthcare13040387.

Abstract

Patient navigation is vital for improving healthcare accessibility and patient experience in China's public hospitals, where high patient demand meets limited medical resources. Patient navigators (PNs) assist patients through the complex healthcare system, but the lack of standardized training and evaluation hampers their ability to meet patient needs. This study piloted a Competencies Improvement Training Program (CITP) in a tertiary hospital to clarify PN competencies, design a feasible curriculum, assess its efficacy, and share insights with peer hospitals. The CITP used the Plan-Do-Check-Act (PDCA) framework and designed a curriculum with Miller's Pyramid Model. Over 6 months, eight sessions were conducted, including theory, case studies, etc. The quasi-experimental design compared PN competencies and patient satisfaction before and after. Multiple instruments measured baseline competencies and program efficacy with a 6-month post-training follow-up. A total of 75 PNs (75%) participated and completed all sessions. A total of 1189 patients were surveyed before training, 495 in the first month after training, and 502 in the 6-month follow-up. The CITP significantly boosted PN competency scores from 90.259 to 95.453, though it dipped to 92.721 by 6 months. Patient satisfaction with PN services improved modestly over 6 months. Challenges in applying theoretical knowledge to practical skills were noted, suggesting differentiated training based on navigator demographics. Patient satisfaction for aspects like politeness and tone was linked to patient age and education. The CITP enhanced PN core competencies and provided an evidence-based curriculum model. Future research should involve larger multi-center populations with longer-term follow-ups to validate the program's effectiveness across diverse settings.

摘要

在中国公立医院,患者需求高而医疗资源有限,患者导航对于改善医疗可及性和患者体验至关重要。患者导航员(PNs)协助患者应对复杂的医疗系统,但缺乏标准化培训和评估阻碍了他们满足患者需求的能力。本研究在一家三级医院试点了一项能力提升培训计划(CITP),以明确PN的能力,设计可行的课程,评估其效果,并与同行医院分享见解。CITP采用计划-执行-检查-行动(PDCA)框架,并使用米勒金字塔模型设计课程。在6个月内进行了8次课程,包括理论、案例研究等。准实验设计比较了前后的PN能力和患者满意度。多种工具测量了基线能力和项目效果,并在培训后6个月进行随访。共有75名PN(75%)参与并完成了所有课程。培训前共调查了1189名患者,培训后第一个月调查了495名,6个月随访时调查了502名。CITP显著提高了PN能力得分,从90.259提高到95.453,不过到6个月时降至92.721。患者对PN服务的满意度在6个月内略有提高。注意到在将理论知识应用于实践技能方面存在挑战,这表明应根据导航员的人口统计学特征进行差异化培训。患者对礼貌和语气等方面的满意度与患者年龄和教育程度有关。CITP增强了PN的核心能力,并提供了一个基于证据的课程模型。未来的研究应纳入更大规模的多中心人群,并进行长期随访,以验证该项目在不同环境中的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/953a/11855021/54a3a9846f44/healthcare-13-00387-g0A1.jpg

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