使用 Kirkpatrick 模型对区域医疗系统的患者体验能力建设项目进行影响评估

Muhammad Hasan Abid, Nada Al Shehri, S. S. Din, Mahmood Mir, Jamal Al Nofeye
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摘要

患者体验 (PX) 是提高医疗服务质量的核心。我们在塔伊夫地区的武装部队医院启动了一项患者体验能力建设计划,该计划是我们地区医疗保健集群转型计划的组成部分,也是发展改善患者医疗保健体验文化的第一步。 一个多学科 PX 委员会招募了五名一线跨专业 PX 负责人,每个地区医疗保健医院各一名。项目评估采用柯克帕特里克模型,以评估对四个关键层面的影响:反应、学习、行为和结果。计划前进行了能力评估,以评估 PX 各项能力的专业水平,并据此制定了计划课程。学员们参加了以工作坊为基础的 PX 能力建设强化培训项目。项目结束后,还进行了能力评估和项目结束后调查。对跨专业的 PX 一线负责人在各自医院开展的 PX 相关活动进行了跟踪调查。通过 Press Ganey PX 调查,衡量了不同环境(包括住院、门诊和急诊环境)对地区 PX 平均分的影响。我们的工作按照 EQUATOR 网络的 SQUIRE-EDU 指南进行报告。 PX 能力建设项目显著提高了参与者在各种 PX 能力方面的专业知识。在整个地区医疗保健系统中,住院部的 PX 平均得分在计划前(83.31)与计划后(86.34)之间有了显著提高,P 值小于 0.001,超出了战略目标。 PX 能力建设计划是我们地区医疗系统在医疗集群转型过程中迈向重大文化变革的第一步。柯克帕特里克模型有助于通过组织方法全面评估 PX 能力建设培训计划的影响。仅通过能力建设项目来长期持续改进 PX 仍具有挑战性。
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Impact Assessment of Patient Experience Capacity-Building Program Using Kirkpatrick Model for Program Evaluation at a Regional Healthcare System
The patient experience (PX) is central to improving the quality of healthcare services. We launched a PX capacity- and capability-building program at the Armed Forces Hospitals Taif Region, which is integral to our regional healthcare cluster transformation plans and is an initial step toward developing a culture of improvement in human experience in healthcare. A multidisciplinary PX committee recruited five frontline interprofessional PX heads, one from each of our regional healthcare hospitals. The Kirkpatrick model for program evaluation was used to assess the impact on four key levels: reaction, learning, behavior, and results. A pre-program competency assessment was conducted to evaluate the level of expertise across various PX competencies, and a program curriculum was developed accordingly. Participants underwent an intensive workshop-based PX capacity-building training program. A post-program competency assessment was performed along with a post-program survey. The PX-related activities led by interprofessional frontline PX heads at their respective hospitals’ post-programs were tracked. The impact on the regional PX mean score across various settings, including inpatient, outpatient, and emergency settings, was measured using Press Ganey PX surveys. Our work is reported in accordance with the SQUIRE-EDU guidelines of the EQUATOR network. The PX capacity-building program led to a significant improvement in participants’ expertise across various PX competencies. Significant improvements beyond the strategic targets were observed in the PX mean score in inpatient departments pre-program (83.31) vs. post-program (86.34), with a p-value of < 0.001 across the regional healthcare system. The PX capacity-building program is a first step toward major cultural change amid the healthcare cluster transformation in our regional healthcare system. The Kirkpatrick model helps evaluate the impact of PX capacity- and capability-building training programs comprehensively through an organizational approach. Sustainable improvements in PX over a long period through a capacity-building program alone remain challenging.
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