A generative response to palliative service capacity in Canada.

Michael Aherne, José Pereira
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引用次数: 11

Abstract

Purpose: This paper situates a large-scale learning and service development capacity-building initiative for hospice palliative care services within the current Canadian policy context for use by international readers.

Design/methodology/approach: In 2000 a national initiative using action research as its design was crafted to support continuing professional development and knowledge management in primary-health care environments.

Findings: The Canadian health policy context is complex and requires innovative solutions to achieve desired changes in response to emerging population health demands for quality end-of-life care. Employment of educational and social science constructs, including complexity theory, communities of practice, transformative learning theory, and workplace learning methods, has proven helpful in supporting the creation of national capacity for hospice palliative care.

Research limitations/implications: There is a significant contribution for social scientists to make in aiding a better understanding of the complexity in health systems. At the same time, an aging population in industrial countries demands more active engagement of legal and bioethical scholars in a range of emerging policy and legislative questions about quality end-of-life care. Educational research is also required to understand better and reform curricula to prepare an emerging generation of health science practitioners for the demands of an aging population.

Practical implications: Changing health service delivery environments demand rethinking of the knowledge and skills leaders require to influence desired change. A broader understanding of where and how learning takes place is essential for enhancing the quality of patient care.

Originality/value: The Pallium Project represents a generative response to facilitating learning and building longer-term system capacity. The journey of project development to date illustrates some important lessons that can be adopted from hospice palliative care to inform other primary-health care initiatives, including, potentially, mental health, cardiology, diabetes, geriatrics, where productive change can result from productively linking specialists and primary-care colleagues.

对加拿大姑息治疗服务能力的生生性反应。
目的:本文在当前加拿大政策背景下,为国际读者提供临终关怀姑息治疗服务的大规模学习和服务发展能力建设倡议。设计/方法/办法:2000年制定了一项采用行动研究作为设计的国家倡议,以支持初级保健环境中的持续专业发展和知识管理。研究结果:加拿大的卫生政策背景复杂,需要创新的解决方案来实现预期的变化,以响应人口对高质量临终关怀的健康需求。运用教育和社会科学建构,包括复杂性理论、实践社群、转型学习理论和工作场所学习方法,已被证明有助于支持国家安宁疗护缓和疗护能力的建立。研究局限性/影响:社会科学家在帮助更好地理解卫生系统的复杂性方面做出了重大贡献。与此同时,工业化国家的人口老龄化要求法律和生物伦理学者更积极地参与一系列关于高质量临终关怀的新政策和立法问题。教育研究也需要更好地理解和改革课程,以培养新一代的卫生科学从业人员,以满足人口老龄化的需求。实际影响:不断变化的卫生服务提供环境要求领导人重新思考影响所期望的变革所需的知识和技能。更广泛地了解学习发生的地点和方式对于提高患者护理质量至关重要。原创性/价值:Pallium项目代表了促进学习和建立长期系统能力的生成性反应。迄今为止的项目发展历程表明,可以从临终关怀姑息治疗中吸取一些重要经验教训,为其他初级保健举措提供参考,这些举措可能包括精神卫生、心脏病学、糖尿病、老年病学,在这些领域,通过将专家和初级保健同事有效地联系起来,可以产生富有成效的变化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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