初级保健中学习保健系统的障碍和促进因素:框架分析。

IF 4.1 Q1 HEALTH CARE SCIENCES & SERVICES
Georgia Fisher, Maree Saba, Genevieve Dammery, Louise A Ellis, Kate Churruca, Janani Mahadeva, Darran Foo, Simon Wilcock, Jeffrey Braithwaite
{"title":"初级保健中学习保健系统的障碍和促进因素:框架分析。","authors":"Georgia Fisher, Maree Saba, Genevieve Dammery, Louise A Ellis, Kate Churruca, Janani Mahadeva, Darran Foo, Simon Wilcock, Jeffrey Braithwaite","doi":"10.1136/bmjhci-2023-100946","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The learning health system (LHS) concept is a potential solution to the challenges currently faced by primary care. There are few descriptions of the barriers and facilitators to achieving an LHS in general practice, and even fewer that are underpinned by implementation science. This study aimed to describe the barriers and facilitators to achieving an LHS in primary care and provide practical recommendations for general practices on their journey towards an LHS.</p><p><strong>Methods: </strong>This study is a secondary data analysis from a qualitative investigation of an LHS in a university-based general practice in Sydney, Australia. A framework analysis was conducted using transcripts from semistructured interviews with clinic staff. Data were coded according to the theoretical domains framework, and then to an LHS framework.</p><p><strong>Results: </strong>91% (n=32) of practice staff were interviewed, comprising general practitioners (n=15), practice nurses (n=3), administrative staff (n=13) and a psychologist. Participants reported that the practice alignment with LHS principles was influenced by many behavioural determinants, some of which were applicable to healthcare in general, for example, some staff lacked <i>knowledge</i> about practice policies and <i>skills</i> in using software. However, many were specific to the general practice environment, for example, the <i>environmental context</i> of general practice meant that administrative staff were an integral part of the LHS, particularly in facilitating partnerships with patients.</p><p><strong>Conclusions: </strong>The LHS journey in general practice is influenced by several factors. Mapping the LHS domains in relation to the theoretical domains framework can be used to generate a roadmap to hasten the journey towards LHS in primary care settings.</p>","PeriodicalId":9050,"journal":{"name":"BMJ Health & Care Informatics","volume":null,"pages":null},"PeriodicalIF":4.1000,"publicationDate":"2024-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11328652/pdf/","citationCount":"0","resultStr":"{\"title\":\"Barriers and facilitators to learning health systems in primary care: a framework analysis.\",\"authors\":\"Georgia Fisher, Maree Saba, Genevieve Dammery, Louise A Ellis, Kate Churruca, Janani Mahadeva, Darran Foo, Simon Wilcock, Jeffrey Braithwaite\",\"doi\":\"10.1136/bmjhci-2023-100946\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The learning health system (LHS) concept is a potential solution to the challenges currently faced by primary care. There are few descriptions of the barriers and facilitators to achieving an LHS in general practice, and even fewer that are underpinned by implementation science. This study aimed to describe the barriers and facilitators to achieving an LHS in primary care and provide practical recommendations for general practices on their journey towards an LHS.</p><p><strong>Methods: </strong>This study is a secondary data analysis from a qualitative investigation of an LHS in a university-based general practice in Sydney, Australia. A framework analysis was conducted using transcripts from semistructured interviews with clinic staff. Data were coded according to the theoretical domains framework, and then to an LHS framework.</p><p><strong>Results: </strong>91% (n=32) of practice staff were interviewed, comprising general practitioners (n=15), practice nurses (n=3), administrative staff (n=13) and a psychologist. Participants reported that the practice alignment with LHS principles was influenced by many behavioural determinants, some of which were applicable to healthcare in general, for example, some staff lacked <i>knowledge</i> about practice policies and <i>skills</i> in using software. However, many were specific to the general practice environment, for example, the <i>environmental context</i> of general practice meant that administrative staff were an integral part of the LHS, particularly in facilitating partnerships with patients.</p><p><strong>Conclusions: </strong>The LHS journey in general practice is influenced by several factors. Mapping the LHS domains in relation to the theoretical domains framework can be used to generate a roadmap to hasten the journey towards LHS in primary care settings.</p>\",\"PeriodicalId\":9050,\"journal\":{\"name\":\"BMJ Health & Care Informatics\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.1000,\"publicationDate\":\"2024-06-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11328652/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMJ Health & Care Informatics\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1136/bmjhci-2023-100946\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Health & Care Informatics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/bmjhci-2023-100946","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0

摘要

背景:学习型医疗系统(LHS)概念是解决目前初级医疗所面临挑战的潜在方案。关于在全科医疗中实现学习型医疗系统的障碍和促进因素的描述很少,而以实施科学为基础的描述就更少了。本研究旨在描述在全科医疗中实现生命健康系统的障碍和促进因素,并为全科医疗在实现生命健康系统的过程中提供实用建议:本研究是对澳大利亚悉尼一所大学的全科实践中的 LHS 进行定性调查后得出的二手数据分析。通过对诊所员工进行半结构化访谈,对访谈记录进行了框架分析。根据理论领域框架对数据进行编码,然后再根据 LHS 框架进行编码:91%(n=32)的医务人员接受了访谈,其中包括全科医生(n=15)、实习护士(n=3)、行政人员(n=13)和一名心理学家。受访者表示,实践与 LHS 原则的一致性受到许多行为决定因素的影响,其中一些因素适用于一般医疗保健,例如,一些员工缺乏对实践政策的了解和使用软件的技能。然而,也有许多因素是全科医疗环境所特有的,例如,全科医疗的环境背景意味着行政人员是生命健康系统不可分割的一部分,特别是在促进与患者的合作方面:结论:全科医生的生命健康服务历程受到多种因素的影响。绘制与理论领域框架相关的 LHS 领域图,可用于生成一个路线图,以加快在初级医疗机构实现 LHS 的进程。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Barriers and facilitators to learning health systems in primary care: a framework analysis.

Background: The learning health system (LHS) concept is a potential solution to the challenges currently faced by primary care. There are few descriptions of the barriers and facilitators to achieving an LHS in general practice, and even fewer that are underpinned by implementation science. This study aimed to describe the barriers and facilitators to achieving an LHS in primary care and provide practical recommendations for general practices on their journey towards an LHS.

Methods: This study is a secondary data analysis from a qualitative investigation of an LHS in a university-based general practice in Sydney, Australia. A framework analysis was conducted using transcripts from semistructured interviews with clinic staff. Data were coded according to the theoretical domains framework, and then to an LHS framework.

Results: 91% (n=32) of practice staff were interviewed, comprising general practitioners (n=15), practice nurses (n=3), administrative staff (n=13) and a psychologist. Participants reported that the practice alignment with LHS principles was influenced by many behavioural determinants, some of which were applicable to healthcare in general, for example, some staff lacked knowledge about practice policies and skills in using software. However, many were specific to the general practice environment, for example, the environmental context of general practice meant that administrative staff were an integral part of the LHS, particularly in facilitating partnerships with patients.

Conclusions: The LHS journey in general practice is influenced by several factors. Mapping the LHS domains in relation to the theoretical domains framework can be used to generate a roadmap to hasten the journey towards LHS in primary care settings.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
6.10
自引率
4.90%
发文量
40
审稿时长
18 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信