Bridging gaps to promote networked care between teams and groups in health delivery systems: a systematic review of non-health literature.
Bridging gaps to promote networked care between teams and groups in health delivery systems: a systematic review of non-health literature.
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DOI：
10.1136/bmjopen-2014-006567
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发表时间：
2015-09-24
期刊：
影响因子：
2.9
通讯作者：
Braithwaite J
中科院分区：
文献类型：
--
作者：
Braithwaite J
为了评估非卫生文献，确定促进更多网络团队和团体的关键策略，将外部想法应用于医疗保健，并基于这些策略建立模型。对医疗保健以外的文献进行系统回顾。在ABI/INFORM Global、CINAHL、IBSS、MEDLINE和Psychinfo数据库的系统评价和荟萃分析首选报告项目（PRISMA）的指导下，通过思维导图练习生成以跨组织社会结构差距核心结构为中心的关键术语，发现842篇实证文章，其中116篇符合纳入标准。通过数据挖掘技术对这些文章进行数据提取和内容分析。这项研究涉及40个国家的受试者，其中32项研究在多个国家招募了参与者。有40项研究全部或部分在美国进行，46项全部或部分在欧洲大陆进行，29项全部或部分在亚洲进行，12项全部或部分在俄罗斯或俄罗斯联邦国家进行。采用的方法包括30个混合或三角社会科学研究设计，39个定性研究，13个实验研究和34个基于问卷的研究，后者主要是为社会网络分析收集数据。四个反复出现的因素支撑着促进网络行为和加强跨群体合作的模型：了解群体之间差距的特征和性质；利用边界跨越者的杠杆作用，在两个或多个群体之间架起桥梁；运用各种机制促进互动关系；动员那些能够施加积极外部影响的人来促进联系，同时尽量减少那些加剧分歧的人的影响。所评估的文献丰富多样。现在有一个面向证据的模型和策略，可以促进更多的网络系统应用于医疗保健。虽然在翻译外部的想法和研究时需要谨慎，但借鉴非卫生方面的想法在为其他部门提供见解方面是有用的。
To assess non-health literature, identify key strategies in promoting more networked teams and groups, apply external ideas to healthcare, and build a model based on these strategies. A systematic review of the literature outside of healthcare. Searches guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) of ABI/INFORM Global, CINAHL, IBSS, MEDLINE and Psychinfo databases following a mind-mapping exercise generating key terms centred on the core construct of gaps across organisational social structures that uncovered 842 empirical articles of which 116 met the inclusion criteria. Data extraction and content analysis via data mining techniques were performed on these articles. The research involved subjects in 40 countries, with 32 studies enrolling participants in multiple countries. There were 40 studies conducted wholly or partly in the USA, 46 wholly or partly in continental Europe, 29 wholly or partly in Asia and 12 wholly or partly in Russia or Russian federated countries. Methods employed included 30 mixed or triangulated social science study designs, 39 qualitative studies, 13 experimental studies and 34 questionnaire-based studies, where the latter was mostly to gather data for social network analyses. Four recurring factors underpin a model for promoting networked behaviours and fortifying cross-group cooperation: appreciating the characteristics and nature of gaps between groups; using the leverage of boundary-spanners to bridge two or more groups; applying various mechanisms to stimulate interactive relationships; and mobilising those who can exert positive external influences to promote connections while minimising the impact of those who exacerbate divides. The literature assessed is rich and varied. An evidence-oriented model and strategies for promoting more networked systems are now available for application to healthcare. While caution needs to be exercised in translating outside ideas and studies, drawing on non-health ideas is useful in providing insights into other sectors.