以干预方式促进全科医疗服务模式转型中实现高价值目标的整群随机试验
发布时间：2018-08-06 16:07
【摘要】：目的本研究旨在探讨针对性与普通干预方法在全科医疗服务模式转型中对目标设定、行动计划及团队绩效的影响。背景全科医疗服务模式的转型在医疗改革中至关重要,但是转型带来的工作量可造成全科医务人员疲惫。积极干预可能会减轻全科医务人员的疲惫感,帮助其实现转型目标,但其较既往研究推荐的方法更明确具体。方法本项为期1年的整群随机试验在8个全科诊所中进行。为达到高基准服务水平(HVEs,基于低服务成本和低资源利用的高服务质量),干预组(4个诊所)给予针对干预,对照组(4个诊所)给予普通干预。对两组的改进质量目标选择、行动项目选择、改进质量结果、HVEs达到程度及协作医疗情况进行定量和定性分析,从而评价两组干预效果。结果试验期间,两组均每月选择改进工作质量目标。1年内干预组平均选择7个改进总体质量和改进HVE的目标、29个行动项目;对照组平均选择8个改进总体质量和改进HVE的目标、40个行动项目。干预组选择的目标83%与HVEs相关,对照组仅27%与HVEs相关。干预组1年内累计选择101个HVE目标,达标率为68%;对照组累计选择41个HVE目标,达标率为61%。干预前后调查结果表明,干预组在协作医疗8个维度中的4个有了很大改进。结论在全科医疗服务模式转型工作中,针对性干预更有利于实现高价值目标,促进团队凝聚力、团队能力及团队责任心的提高。
[Abstract]:Objective to explore the effects of targeted and common intervention on goal setting, action plan and team performance in the transformation of general practice medical service model. Background the transformation of the general medical service mode is very important in the medical reform, but the workload brought by the transformation can cause fatigue of the general medical staff. Active intervention may alleviate the fatigue of general practitioners and help them to achieve the goal of transformation, but it is more specific than the methods recommended by previous studies. Methods A 1-year cluster randomized trial was conducted in 8 general practice clinics. In order to achieve a high standard service level (HVEs, based on low service cost and high quality of service with low resource utilization), the intervention group (4 clinics) was given intervention, while the control group (4 clinics) was given general intervention. Quantitative and qualitative analysis was carried out on the choice of improving quality goal, the selection of action items, the degree of HVEs' achievement and the medical condition of cooperation between the two groups, so as to evaluate the effect of intervention between the two groups. Results during the trial period, the two groups selected the goal of improving the quality of work every month. Within one year, the intervention group selected 7 targets to improve the overall quality and improve the HVE, 29 action items. The control group selected an average of 8 goals to improve overall quality and improve HVE, and 40 action items. In the intervention group, 83% of the selected targets were related to HVEs, while only 27% in the control group were related to HVEs. In the intervention group, 101 HVE targets were selected in one year, and the rate of reaching the standard was 68. In the control group, 41 HVE targets were selected, and the rate of reaching the standard was 61. The results before and after intervention showed that the intervention group had a great improvement in 4 of the eight dimensions of collaborative medical care. Conclusion in the transformation of general practice medical service mode, targeted intervention is more conducive to achieving high value goals, promoting team cohesion, team ability and team responsibility.
【分类号】：R197.1
本文编号：2168250
[Abstract]:Objective to explore the effects of targeted and common intervention on goal setting, action plan and team performance in the transformation of general practice medical service model. Background the transformation of the general medical service mode is very important in the medical reform, but the workload brought by the transformation can cause fatigue of the general medical staff. Active intervention may alleviate the fatigue of general practitioners and help them to achieve the goal of transformation, but it is more specific than the methods recommended by previous studies. Methods A 1-year cluster randomized trial was conducted in 8 general practice clinics. In order to achieve a high standard service level (HVEs, based on low service cost and high quality of service with low resource utilization), the intervention group (4 clinics) was given intervention, while the control group (4 clinics) was given general intervention. Quantitative and qualitative analysis was carried out on the choice of improving quality goal, the selection of action items, the degree of HVEs' achievement and the medical condition of cooperation between the two groups, so as to evaluate the effect of intervention between the two groups. Results during the trial period, the two groups selected the goal of improving the quality of work every month. Within one year, the intervention group selected 7 targets to improve the overall quality and improve the HVE, 29 action items. The control group selected an average of 8 goals to improve overall quality and improve HVE, and 40 action items. In the intervention group, 83% of the selected targets were related to HVEs, while only 27% in the control group were related to HVEs. In the intervention group, 101 HVE targets were selected in one year, and the rate of reaching the standard was 68. In the control group, 41 HVE targets were selected, and the rate of reaching the standard was 61. The results before and after intervention showed that the intervention group had a great improvement in 4 of the eight dimensions of collaborative medical care. Conclusion in the transformation of general practice medical service mode, targeted intervention is more conducive to achieving high value goals, promoting team cohesion, team ability and team responsibility.
【分类号】：R197.1
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