改善社区肢体康复护理协调:变化框架的定性研究

J. Symons, Julie Jamison, Jane Dening, L. Murray, Sue Pearson
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引用次数: 3

摘要

当代康复变革依赖于利益相关者之间的有效合作和持续的社会互动。本研究的目的是探讨在护理协调改善项目中所选择的改变框架和潜在的社会互动的影响。方法对某社区肢体康复服务机构35名员工进行定性调查。参与者不仅在进行变革以改善客户服务协调,而且也在促进变革过程本身。符号互动主义指导研究设计,采用访谈法和观察法收集数据。Blumer的六个根信念被用于演绎数据分析,并为研究结果提供了框架。结果研究结果强调,所选择的变化框架的看法是混合的,但动态的,修改发生通过社会互动。科特的八个步骤,精益思维和转型变革模型的元素进行了试验。变革过程的实施需要正式和非正式的群体社会互动。参与者的不同观点解释了他们对变革过程的不同反应。支持实施变更的参与者认为流程和结果是清晰、适当和包容的。时间、精力和积极的社会互动使员工能够推动变革,需要更多的这些资源来完善愿景、解决问题的实施,并进一步改善护理协调。本研究增进了对员工与社区肢体康复服务在变革过程中如何相互塑造的理解。对社会互动的关注突出了改善护理协调的速度缓慢,需要增加资源和/或持续时间才能成功改变。
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Improving care coordination in community physical rehabilitation: A qualitative study of the change framework
Introduction Contemporary rehabilitation change relies on effective collaboration and ongoing social interactions among stakeholders. The study objective was to explore the influence of the selected change framework and underlying social interactions during a care coordination improvement project. Methods A qualitative study collected data from 35 employees in a community physical rehabilitation service. Participants were not only undergoing change to improve client care coordination but were also facilitating the change processes themselves. Symbolic interactionism guided the research design, and data were collected using interviews and observation. Blumer’s six root beliefs were used for deductive data analysis and provided the framework for the findings. Results Findings highlight that the perceptions of the selected change framework were mixed yet dynamic, with modification occurring via social interaction. Elements of Kotter’s eight steps, lean thinking, and transformational change models were trialed. Implementation of the change processes required formal and informal group social interactions. Participants’ different outlooks explained their mixed response to the change processes. Participants who supported the implemented changes believed the processes and outcomes were clear, appropriate, and inclusive. Time, energy, and positive social interactions enabled employees to drive change, with more of these resources desired to refine the vision, problem-solve implementation, and further improve care coordination. Discussion This study enhances the understanding of how employees and the community physical rehabilitation service shaped each other during the change processes. The focus on social interactions highlights the slow rate of improved care coordination and need for increased resources and/or duration for successful change.
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来源期刊
CiteScore
3.10
自引率
14.30%
发文量
15
期刊介绍: The International Journal of Care Coordination (formerly published as the International Journal of Care Pathways) provides an international forum for the latest scientific research in care coordination. The Journal publishes peer-reviewed original articles which describe basic research to a multidisciplinary field as well as other broader approaches and strategies hypothesized to improve care coordination. The Journal offers insightful overviews and reflections on innovation, underlying issues, and thought provoking opinion pieces in related fields. Articles from multidisciplinary fields are welcomed from leading health care academics and policy-makers. Published articles types include original research, reviews, guidelines papers, book reviews, and news items.
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