使用学习卫生系统原则嵌入初级保健患者体验数据:一项定性调查。

IF 1.9 4区 医学 Q3 HEALTH POLICY & SERVICES
Louise A Ellis, Georgia Fisher, Kate Churruca, Maree Saba, Tanja Schroeder, Janani Mahadeva, Sanjyot Vagholkar, Mark Yang Lee, Reema Harrison, Simon Willcock, Jeffrey Braithwaite
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引用次数: 0

摘要

背景:虽然是高质量医疗保健的重要组成部分,但患者经验数据的常规收集在初级保健中是有限的,关于如何使用这些数据来提高质量的证据也是有限的。本研究使用学习卫生系统(LHS)框架来描述大学附属社区全科医生如何将患者体验数据整合到服务和质量改进工作中,并确定障碍和促进因素。方法:与澳大利亚一所大学附属全科诊所的学术研究人员和工作人员共同设计定性案例研究。2024年4月与实习人员进行了半结构化访谈,并根据五域学习卫生系统框架对笔录进行演绎编码,并添加了捕获障碍和促进因素的额外代码。结果:采访了18名(53%)执业人员,包括全科医生(n = 11),一名执业护士(n = 1)和行政人员(n = 6)。参与者确定了多种方法,通过这些方法,执业人员捕获了跨越LHS框架所有领域的患者体验。然而,很少有证据表明采用了连贯的质量改进战略,并在工作人员工作量、培训和现有政府资助政策方面发现了相关障碍。使用患者经验数据的主要促进因素包括:较大的卫生组织和大学的成员资格;主要专门的行政和临床角色;有效的领导,管理结构和政策,以支持持续学习和推动服务改进。结论:本研究提供了一个案例示例,说明如何将患者体验数据集成到一般实践中,并确定了启动和转换这些数据以持续改善医疗保健的关键障碍和促进因素。通过将患者体验数据的使用映射到LHS框架,本研究展示了如何将LHS原则应用于初级保健,以促进持续获取和使用患者体验数据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Using Learning Health System Principles to Embed Patient Experience Data in Primary Care: A Qualitative Investigation.

Background: Though an important component of high-quality healthcare, the routine collection of patient experience data is limited in primary care, as is the evidence for how this data is being used for quality improvement. This study used a learning health system (LHS) framework to describe how a university-affiliated community general practice is integrating patient experience data into service and quality improvement efforts, and to identify barriers and facilitators.

Methods: A co-designed qualitative case study was conducted with academic researchers and staff from a university-affiliated general practice in Australia. Semi-structured interviews were conducted in April 2024 with practice staff, and transcripts were deductively coded according to a five-domain learning health systems framework, and with additional codes capturing barriers and facilitators.

Results: Eighteen (53%) practice staff were interviewed, including general practitioners (n = 11), a practice nurse (n = 1), and administrative staff (n = 6). Participants identified multiple methods through which the practice captured the patient experience that spanned all domains of the LHS framework. However, there was less evidence of a coherent quality improvement strategy being employed, with associated barriers identified around staff workloads, training, and existing government funding policies. Key facilitators to the use of patient experience data included: membership of a larger health organisation and university; key dedicated administrative and clinical roles; and effective leadership, governance structures and policies to support continuous learning and drive service improvement.

Conclusion: This study presents a case example of how patient experience data is being integrated into general practice and identifies key barriers and facilitators to initiating and translating this data for continuous healthcare improvement. By mapping the use of patient experience data to a LHS framework, this study shows how LHS principles can be applied to primary care to facilitate the capture and use of patient experience data on an ongoing basis.

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来源期刊
CiteScore
4.50
自引率
3.70%
发文量
197
期刊介绍: Policy making and implementation, planning and management are widely recognized as central to effective health systems and services and to better health. Globalization, and the economic circumstances facing groups of countries worldwide, meanwhile present a great challenge for health planning and management. The aim of this quarterly journal is to offer a forum for publications which direct attention to major issues in health policy, planning and management. The intention is to maintain a balance between theory and practice, from a variety of disciplines, fields and perspectives. The Journal is explicitly international and multidisciplinary in scope and appeal: articles about policy, planning and management in countries at various stages of political, social, cultural and economic development are welcomed, as are those directed at the different levels (national, regional, local) of the health sector. Manuscripts are invited from a spectrum of different disciplines e.g., (the social sciences, management and medicine) as long as they advance our knowledge and understanding of the health sector. The Journal is therefore global, and eclectic.
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