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关于基层医疗实践团队应如何组织事件分析的德尔菲分析。

Delphi analysis of how the practice team should organise event analysis in primary care.

作者信息

Hanley Karena, McNab Duncan, Bowie Paul, Pellowe Alexia, Rainey Veronica

机构信息

NHS Education for Scotland, Edinburgh, UK

NHS Education for Scotland, Edinburgh, UK.

出版信息

BMJ Open Qual. 2025 Jul 13;14(3):e003282. doi: 10.1136/bmjoq-2024-003282.

Abstract

INTRODUCTION

Significant event analysis is a common quality improvement activity in UK general practice (GP). How well do general practice (GP) teams conduct their analyses? There is little guidance and no measuring tool. This is a Delphi analysis among Scottish multidisciplinary primary care team members to establish a set of quality indicators by which practices can self-assess their practice processes in conducting their event analyses.

METHODS

A Delphi method specifically for identifying quality indicators in healthcare was used. Purposeful selection was of primary care team members with known experience of significant event analysis; informed participants. After setting a consensus score, 29 items for the first round Delphi survey, drawn from the literature, were sent out with the ability to comment on each. The second Delphi round contained those items which had passed the consensus score, the aggregated comments on those items and any suggestions for new items.

RESULTS

Of 24 informed participants approached, 10 (37.5%) agreed to undertake the full cycle of the Delphi process. 17 items from the first Delphi survey passed the consensus score with one additional item suggested. With the amalgamation of items, 16 statements were presented in the second Delphi, of which 15 passed the consensus score.

CONCLUSIONS

Learnings from our Delphi are that practitioners prefer the term 'learning event analysis' to 'significant event analysis', and that practice nurses may need specific encouragement to become more involved in event analysis. There is reluctance to involve patients or patient representatives in the event analysis itself. Engagement in well-conducted event analysis strengthens the whole practice team.

摘要

引言

重大事件分析是英国全科医疗(GP)中一项常见的质量改进活动。全科医疗团队的分析工作开展得如何?几乎没有相关指导,也没有衡量工具。这是一项针对苏格兰多学科基层医疗团队成员的德尔菲分析,旨在建立一套质量指标,以便各医疗机构能够自我评估其在进行事件分析时的实践过程。

方法

采用了一种专门用于确定医疗保健质量指标的德尔菲方法。有目的地挑选了具有重大事件分析经验的基层医疗团队成员;参与者了解相关情况。在设定了共识分数后,第一轮德尔菲调查从文献中选取了29个项目并发送出去,参与者能够对每个项目发表评论。第二轮德尔菲调查包含通过了共识分数的项目、对这些项目的综合评论以及任何新项目的建议。

结果

在联系的24名了解情况的参与者中,10名(37.5%)同意参与德尔菲过程的完整周期。第一轮德尔菲调查中的17个项目通过了共识分数,另外还提出了一个项目。经过项目合并,第二轮德尔菲调查提出了16条陈述,其中15条通过了共识分数。

结论

我们从德尔菲分析中学到,从业者更喜欢用“学习事件分析”这个术语,而不是“重大事件分析”,并且可能需要特别鼓励实习护士更多地参与事件分析。人们不愿意让患者或患者代表参与事件分析本身。参与开展良好的事件分析会加强整个医疗团队的协作。

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