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工作场所文化在成功实施生活方式医学中的作用:美国卫生系统中的定性案例系列研究

Role of workplace culture in successful lifestyle medicine implementation: a qualitative case series among health systems in the USA.

作者信息

Durrwachter Neve, Ames Meghan L, Gittelsohn Joel, Hemmingson Tyler A, Reznar Melissa M, Staffier Kara L, Sundermeir Samantha M, Weeks Bruce, Karlsen Micaela C

机构信息

Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

American College of Lifestyle Medicine, Chesterfield, Missouri, USA.

出版信息

BMJ Open. 2025 Mar 5;15(3):e087184. doi: 10.1136/bmjopen-2024-087184.

Abstract

OBJECTIVE

This study investigated how workplace culture may affect the development of lifestyle medicine (LM) programming in health systems to inform the successful growth of LM programs. No study has examined how the impact of workplace culture (shared knowledge, values and behaviours within an organisation) affects practitioners' abilities to engage in LM.

DESIGN

A cross-sectional, multiple case study investigation of the implementation of LM in five health systems was conducted by administering semi-structured in-depth interviews (n=45) from May 2022 to January 2023. Following the transcription of interviews verbatim, narrative reports depicting each health system's experience with LM were drafted and collectively reviewed by the research team who discussed emerging themes.

SETTING

Five health systems across the USA that have implemented LM were selected based on diversity in size, location, payer model, and patient population.

PARTICIPANTS

Administrative leaders, physicians and other personnel involved in the LM programming from selected health systems were invited to participate.

RESULTS

The implementation of LM is facilitated when practices such as forming social groups, visually advertising LM and offering plant-based cafeteria items are present to support core values, such as trust, gratitude, collaboration and optimism.

CONCLUSIONS

LM implementation can be supported by health system clinicians and administrators striving to make their workplaces more supportive and synergetic so that they can take advantage of all available resources. Future research should further explore this relationship between cultural factors and resource availability.

摘要

目的

本研究调查了工作场所文化如何影响卫生系统中生活方式医学(LM)项目的发展,以为LM项目的成功发展提供信息。尚无研究考察工作场所文化(组织内共享的知识、价值观和行为)的影响如何作用于从业者参与LM的能力。

设计

2022年5月至2023年1月,通过进行半结构化深度访谈(n = 45),对五个卫生系统中LM的实施情况开展了一项横断面多案例研究调查。访谈逐字转录后,研究团队起草了描述每个卫生系统LM实施经验的叙述性报告,并共同审查,讨论新出现的主题。

背景

根据规模、地点、支付模式和患者群体的多样性,在美国选择了五个已实施LM的卫生系统。

参与者

邀请了选定卫生系统中参与LM项目的行政领导、医生和其他人员参与。

结果

当存在诸如组建社交团体、直观宣传LM以及在自助餐厅提供植物性食品等做法来支持信任、感恩、协作和乐观等核心价值观时,LM的实施会得到促进。

结论

卫生系统的临床医生和管理人员努力使工作场所更具支持性和协同性,以便能够利用所有可用资源,从而支持LM的实施。未来的研究应进一步探讨文化因素与资源可用性之间的这种关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce25/11883603/fd663469ac90/bmjopen-15-3-g001.jpg

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