Integrating Community Health Workers (CHWs) into Health Care Organizations
Integrating Community Health Workers (CHWs) into Health Care Organizations
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DOI：
10.1007/s10900-017-0345-4
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发表时间：
2017-10-01
影响因子：
5.9
通讯作者：
Tardif-Douglin, Miriam
中科院分区：
文献类型：
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作者：
Payne, Julianne;Razi, Sima;Tardif-Douglin, Miriam
医疗保健组织越来越多地雇用社区卫生工作者 (CHW) 来帮助解决日益严重的医疗服务提供者短缺问题，改善患者治疗效果，并增加传统上无法获得或被剥夺权利的患者群体获得文化敏感护理的机会。近几十年来，学术界对社区卫生工作者的兴趣不断增长，但研究人员倾向于关注社区卫生工作者如何影响患者的治疗结果，而不是社区卫生工作者是否以及如何融入现有的医疗保健队伍。本文重点讨论促进和阻碍社区卫生工作者融入医疗保健组织的因素，以及组织及其员工为克服社区卫生工作者融入障碍而制定的策略。我们使用 13 名获得医疗保险和医疗补助创新中心医疗保健创新奖的获奖者的定性评估数据，通过涉及社区卫生工作者的项目来提高医疗保健质量、改善健康结果并降低医疗成本。我们发现组织能力、对社区卫生工作者的支持、医疗保健角色的明确性以及临床工作流程推动了社区卫生工作者的整合。最后，我们为有兴趣雇用社区卫生工作者的医疗保健组织提出了实用建议。
Health care organizations increasingly employ community health workers (CHWs) to help address growing provider shortages, improve patient outcomes, and increase access to culturally sensitive care among traditionally inaccessible or disenfranchised patient populations. Scholarly interest in CHWs has grown in recent decades, but researchers tend to focus on how CHWs affect patient outcomes rather than whether and how CHWs fit into the existing health care workforce. This paper focuses on the factors that facilitate and impede the integration of the CHWs into health care organizations, and strategies that organizations and their staff develop to overcome barriers to CHW integration. We use qualitative evaluation data from 13 awardees that received Health Care Innovation Awards from the Centers of Medicare and Medicaid Innovation to enhance the quality of health care, improve health outcomes, and reduce the cost of care using programs involving CHWs. We find that organizational capacity, support for CHWs, clarity about health care roles, and clinical workflow drive CHW integration. We conclude with practical recommendations for health care organizations interested in employing CHWs.