Identifying potential outcomes of patient engagement in primary care quality improvement: a modified Delphi study.

IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Journal of evaluation in clinical practice Pub Date : 2024-10-16 DOI:10.1111/jep.14199
Nancy Pandhi, Nora Jacobson, Madison Crowder, Andrew Quanbeck, Sarah Davis
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引用次数: 0

Abstract

Rationale: A barrier to dedicating resources towards patient engagement in primary care quality improvement is the lack of clearly identified outcomes that might result from these initiatives.

Aims and objectives: We sought to identify these potential outcomes at three healthcare levels as defined by the Institute of Medicine: 1) Micro/Direct Care; 2) Meso/Microsystem; and 3) Macro/Clinic/System using a Modified Delphi technique.

Method: Two focus groups of patients and primary care clinician leaders generated a first set of outcomes. These outcomes were then vetted and expanded through three web-based surveys sent to twelve national experts. Experts indicated the level of agreement with prior elicited outcomes and generated potential new outcomes.

Results: Included outcomes achieved at least 80% agreement. The final list of 46 consensus-derived outcomes was categorized across levels. 22 were at the Micro-level, 9 were at the Meso-level, and 15 were at the Macro-level.

Conclusion: Our findings suggest outcomes across all health system levels have the potential for progress when patients are engaged in primary care quality improvement initiatives. Future programs should consider validating and measuring these outcomes as part of their interventions.

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确定患者参与初级医疗质量改进的潜在结果:改良德尔菲研究。
理由将资源用于患者参与初级医疗质量改进的一个障碍是缺乏明确确定的这些举措可能产生的结果:我们试图从医学研究所定义的三个医疗保健层面来确定这些潜在的成果:1) 微观/直接护理;2) 中观/微观系统;3) 宏观/诊所/系统:方法:由患者和初级保健临床医生领导组成的两个焦点小组产生了第一组结果。然后,通过向 12 位国内专家发送三份网络调查问卷,对这些成果进行审核和扩展。专家们指出了与之前所征集结果的一致程度,并提出了潜在的新结果:结果:所包含的成果至少达到 80% 的一致程度。46 项共识成果的最终清单按级别进行了分类。22 项属于微观层面,9 项属于中观层面,15 项属于宏观层面:我们的研究结果表明,当患者参与初级医疗质量改进计划时,所有医疗系统层面的结果都有可能取得进展。未来的计划应考虑验证和测量这些结果,并将其作为干预措施的一部分。
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来源期刊
CiteScore
4.80
自引率
4.20%
发文量
143
审稿时长
3-8 weeks
期刊介绍: The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.
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