Collective learning, change and improvement in health care: trialling a facilitated learning initiative with general practice teams
Collective learning, change and improvement in health care: trialling a facilitated learning initiative with general practice teams
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DOI：
10.1111/j.1365-2753.2011.01641.x
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发表时间：
2012-06-01
影响因子：
2.4
通讯作者：
Kelly, Diane
中科院分区：
文献类型：
--
作者：
Bunniss, Suzanne;Gray, Francesca;Kelly, Diane
基本原理、宗旨和目标 许多患者、家庭、医疗保健专业人员和政治家希望提高英国国民医疗服务质量。实现这一变革的方法之一是医疗保健团队更有效地合作和学习。本研究旨在设计和试验一项促进学习计划，旨在支持全科实践团队培养学习型组织的特征。方法这是一项行动研究。试验期间和试验后，来自苏格兰不同卫生委员会两个多专业全科医疗团队的 40 名参与者收集了定性数据。通过观察、半结构化访谈和书面学习笔记收集数据。结果 参加 LPP 是一种共同学习的积极体验，也是一种特殊的结果，加强团队内部的沟通。外部促进有助于集中注意力并减少专业间障碍。团队发现，在小型、混合角色的讨论小组中工作对于理解彼此的观点特别有价值。 LPP 的主动学习风格有时可能令人望而生畏，但团队很重视确定自己质量改进目标的机会。由于他们的参与，团队引入了许多变革，以提高其实践中的护理质量。结论 学习实践计划的试验表明，通过便利和适当的资源投入，全科实践团队可以成功应用学习组织原则来产生质量改进成果。该研究还证明了行动研究在研究随时间推移的迭代变化方面的价值。
Rationale, aims and objectives Many patients, families, health care professionals and politicians desire for quality improvement within the UK National Health Service. One way to achieve this change is for health care teams to work and learn together more effectively. This research aimed to design and trial a facilitated learning programme with the aim of supporting general practice teams in fostering the characteristics of learning organizations. Methods This is an action research study. Qualitative data were captured during and after the trial from 40 participants in two multi-professional general practice teams within different Scottish health boards. Data were gathered using observations, semi-structured interviews and written learning notes. Results Taking part in the LPP was a positive experience of learning together as a practice and enhanced communication within the team was a particular outcome. External facilitation helped provide focus and reduce inter-professional barriers. Teams found working in small, mixed role discussion groups particularly valuable in understanding each others' perspectives. The active learning style of the LPP could be daunting at times but teams valued the chance to identify their own quality improvement goals. Teams introduced a number of changes to improve the quality of care within their practice as a result of their participation. Conclusion This trial of the learning practice programme shows that, with facilitation and the appropriate input of resources, general practice teams can successfully apply learning organization principles to produce quality improvement outcomes. The study also demonstrates the value of action research in researching iterative change over time.