如何实施病人经验调查和使用他们的发现服务改进:定性专家咨询研究在澳大利亚全科医生。

Hyun Jung Song, Sarah Dennis, Jean-Frédéric Levesque, Mark Harris
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引用次数: 6

摘要

目的:确定在澳大利亚全科医疗中实施患者体验调查时要考虑的障碍(患者、提供者、实践和系统水平),并使其能够系统地使用,以告知临床实践和更广泛的卫生系统中的服务改进。方法与分析:采用专家咨询和定性内容分析的横断面、开放式调查数据。数据收集自主要国际和澳大利亚专家在测量和质量改进领域的一般做法。结果:来自6个国家的20名参与者参与了这项研究。与会者讨论了确保调查对利益攸关方的价值和相关性的重要性。缺乏资源、信息技术基础设施、能力建设和持续资金被认为是实施调查的障碍。与会者讨论了明确定义和沟通调查目的的重要性,并同意在实践层面上利用患者经验为反思性、基于团队的学习提供信息的价值。在系统层面对患者体验数据的使用存在不同意见,一些人质疑其在外部绩效报告中的效用或公平性。其他人建议在某些条件下汇总和报告这些数据,包括与其他质量和结果数据进行三角测量的目的。该研究确定了在实践和系统层面对患者体验数据的评估和解释方面的证据差距,包括在系统层面对调查结果的分析和背景化。结论:患者体验调查具有指导执业水平质量提高的潜力,但实施过程中仍存在诸多障碍。有必要进行更多的研究和政策努力,以了解如何在系统层面上利用这些信息来改善澳大利亚的一般做法。
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How to implement patient experience surveys and use their findings for service improvement: a qualitative expert consultation study in Australian general practice.

Objective: To identify barriers (patient, provider, practice and system levels) to consider when implementing patient experience surveys in Australian general practice and enablers of their systematic use to inform service improvement in clinical practice as well as the broader health system.

Methods and analysis: An expert consultation and qualitative content analysis of cross-sectional, open-text survey data. Data were collected from key international and Australian experts in the areas of measurement and quality improvement in general practice.

Results: Responses from 20 participants from six countries were included in the study. Participants discussed the importance of ensuring value and relevance of surveys to stakeholders. Lack of resources, IT infrastructure, capacity building and sustained funding were identified as barriers to implementing surveys. Participants discussed the importance of clearly defining and communicating the purpose of surveys and agreed on the value of using patient experience to inform reflective, team-based learning at the practice level. Opinions differed on the use of patient experience data at the system level, with some questioning its utility or fairness for external performance reporting. Others recommended the aggregation and reporting of these data under certain conditions, including for the purpose of triangulation with other quality and outcome data. The study identified an evidence gap in the assessment and interpretation of patient experience data at the practice and system levels, including the analysis and contextualisation of survey findings at the system level.

Conclusion: Patient experience surveys have potential for guiding practice level quality improvement, but many barriers to their implementation remain. There is need for greater research and policy efforts to understand how this information can be used at the system level for improving Australian general practice.

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