【摘要】：目的本研究旨在探討針對性與普通干預(yù)方法在全科醫(yī)療服務(wù)模式轉(zhuǎn)型中對目標設(shè)定、行動計劃及團隊績效的影響。背景全科醫(yī)療服務(wù)模式的轉(zhuǎn)型在醫(yī)療改革中至關(guān)重要,但是轉(zhuǎn)型帶來的工作量可造成全科醫(yī)務(wù)人員疲憊。積極干預(yù)可能會減輕全科醫(yī)務(wù)人員的疲憊感,幫助其實現(xiàn)轉(zhuǎn)型目標,但其較既往研究推薦的方法更明確具體。方法本項為期1年的整群隨機試驗在8個全科診所中進行。為達到高基準服務(wù)水平(HVEs,基于低服務(wù)成本和低資源利用的高服務(wù)質(zhì)量),干預(yù)組(4個診所)給予針對干預(yù),對照組(4個診所)給予普通干預(yù)。對兩組的改進質(zhì)量目標選擇、行動項目選擇、改進質(zhì)量結(jié)果、HVEs達到程度及協(xié)作醫(yī)療情況進行定量和定性分析,從而評價兩組干預(yù)效果。結(jié)果試驗期間,兩組均每月選擇改進工作質(zhì)量目標。1年內(nèi)干預(yù)組平均選擇7個改進總體質(zhì)量和改進HVE的目標、29個行動項目;對照組平均選擇8個改進總體質(zhì)量和改進HVE的目標、40個行動項目。干預(yù)組選擇的目標83%與HVEs相關(guān),對照組僅27%與HVEs相關(guān)。干預(yù)組1年內(nèi)累計選擇101個HVE目標,達標率為68%;對照組累計選擇41個HVE目標,達標率為61%。干預(yù)前后調(diào)查結(jié)果表明,干預(yù)組在協(xié)作醫(yī)療8個維度中的4個有了很大改進。結(jié)論在全科醫(yī)療服務(wù)模式轉(zhuǎn)型工作中,針對性干預(yù)更有利于實現(xiàn)高價值目標,促進團隊凝聚力、團隊能力及團隊責任心的提高。
[Abstract]:Objective to explore the effects of targeted and common intervention on goal setting, action plan and team performance in the transformation of general practice medical service model. Background the transformation of the general medical service mode is very important in the medical reform, but the workload brought by the transformation can cause fatigue of the general medical staff. Active intervention may alleviate the fatigue of general practitioners and help them to achieve the goal of transformation, but it is more specific than the methods recommended by previous studies. Methods A 1-year cluster randomized trial was conducted in 8 general practice clinics. In order to achieve a high standard service level (HVEs, based on low service cost and high quality of service with low resource utilization), the intervention group (4 clinics) was given intervention, while the control group (4 clinics) was given general intervention. Quantitative and qualitative analysis was carried out on the choice of improving quality goal, the selection of action items, the degree of HVEs' achievement and the medical condition of cooperation between the two groups, so as to evaluate the effect of intervention between the two groups. Results during the trial period, the two groups selected the goal of improving the quality of work every month. Within one year, the intervention group selected 7 targets to improve the overall quality and improve the HVE, 29 action items. The control group selected an average of 8 goals to improve overall quality and improve HVE, and 40 action items. In the intervention group, 83% of the selected targets were related to HVEs, while only 27% in the control group were related to HVEs. In the intervention group, 101 HVE targets were selected in one year, and the rate of reaching the standard was 68. In the control group, 41 HVE targets were selected, and the rate of reaching the standard was 61. The results before and after intervention showed that the intervention group had a great improvement in 4 of the eight dimensions of collaborative medical care. Conclusion in the transformation of general practice medical service mode, targeted intervention is more conducive to achieving high value goals, promoting team cohesion, team ability and team responsibility.
【分類號】：R197.1

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