让医疗保健专业人员参与质量改进:一项定性研究,探索丹麦质量改进合作实施中专业化和制度化项目之间的协同作用。

IF 1.9 4区 医学 Q3 HEALTH POLICY & SERVICES Journal of Health Services Research & Policy Pub Date : 2024-07-01 Epub Date: 2024-02-02 DOI:10.1177/13558196241231169
Kathrine Carstensen, Joanne Goldman, Anne Mette Kjeldsen, Stina Lou, Camilla Palmhøj Nielsen
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引用次数: 0

摘要

目的研究丹麦医疗保健专业人员参与质量改进合作(QIC)实施的专业化和制度化项目,并分析这两个项目在QIC提供的机会下的协同作用和紧张关系:这是一项横断面访谈研究,研究对象是参与丹麦两个全国性质量改进合作项目实施的专业人员,共进行了 23 次个人访谈和焦点小组讨论,75 人代表了不同的专业群体。我们借鉴机构对专业组织研究的贡献,对数据进行了反思性专题分析:结果:研究参与者广泛参与了 QIC 的实施。这种参与是由各专业的专业化和制度化项目之间的建设性互动形成的,只发现了少数紧张关系。专业化项目与贡献专业知识、促进专业认可和发展的自我导向议程有关,而制度化项目则侧重于改善医疗保健流程和结果以及推进质量改进。这两个项目在各专业组之间大体相似。两个项目之间的相互作用得益于自下而上的实施方法、质量改进专家的参与,以及对发展和提供高质量病人护理的明确关注:结论:未来的质量信息交流中心实施战略应将质量信息交流中心定位为一个框架,促进各专业的专业化和制度化项目的整合,使专业人员成功参与到实施过程中,从而优化质量信息交流中心在医疗保健中的有效性。
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Engaging health care professionals in quality improvement: A qualitative study exploring the synergies between projects of professionalisation and institutionalisation in quality improvement collaborative implementation in Denmark.

Objective: To examine the projects of professionalisation and institutionalisation forming health care professions' engagement in quality improvement collaborative (QIC) implementation in Denmark, and to analyse the synergies and tensions between the two projects given the opportunities afforded by the QICs.

Methods: This was a cross-sectional interview study with professionals involved in the implementation of two national QICs in Denmark involving 23 individual interviews and focus group discussions with 75 people representing different professional groups. We conducted a reflexive thematic analysis of the data, drawing on institutional contributions to organisational studies of professions.

Results: Study participants engaged widely in QIC implementation. This engagement was formed by a constructive interplay between the professions' projects of professionalisation and institutionalisation, with only few tensions identified. The project of professionalisation relates to a self-oriented agenda of contributing professional expertise and promoting professional recognition and development, while the project of institutionalisation focuses on improving health care processes and outcomes and advancing quality improvement. Both projects were largely similar across professional groups. The interplay between the two projects was enabled by the bottom-up approach to implementation, participation of QI specialists, and a clear focus on developing and delivering high-quality patient care.

Conclusions: Future strategies for QIC implementation should position QICs as a framework that promotes the integration of professions' projects of professionalisation and institutionalisation to successfully engage professionals in the implementation process, and thereby optimise the effectiveness of QICs in health care.

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来源期刊
CiteScore
4.40
自引率
4.20%
发文量
39
期刊介绍: Journal of Health Services Research & Policy provides a unique opportunity to explore the ideas, policies and decisions shaping health services throughout the world. Edited and peer-reviewed by experts in the field and with a high academic standard and multidisciplinary approach, readers will gain a greater understanding of the current issues in healthcare policy and research. The journal"s strong international editorial advisory board also ensures that readers obtain a truly global and insightful perspective.
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