Professional groups driving change toward patient-centred care: interprofessional working in stroke rehabilitation in Denmark
Professional groups driving change toward patient-centred care: interprofessional working in stroke rehabilitation in Denmark
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DOI：
10.1186/s12913-017-2603-7
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发表时间：
2017-09-16
影响因子：
2.8
通讯作者：
Kuhlmann, Ellen
中科院分区：
文献类型：
--
作者：
Burau, Viola;Carstensen, Kathrine;Kuhlmann, Ellen
背景：基于需求的以患者为中心的护理在卫生政策和劳动力中得到了越来越多的支持。这对跨专业团队产生了新的需求，并重新定义了专业人员的角色和任务，但人们对如何更有效地实施新的卫生政策知之甚少。我们的目的是分析卫生专业人员在推动跨专业工作和以患者为中心的护理方面的组织变革中的作用和能力。方法：对丹麦在中风康复中引入跨专业、早期出院团队进行了案例研究，重点关注护理任务的日常协调以及专业团体的利益和策略。该研究包括 5 个中风团队，并于 2015 年对不同的健康专业人员进行了 17 次访谈。 结果：专业团体对重组中风康复在患者、专业实践和部门间关系方面表达了高度积极的专业兴趣；个人专业和集体跨专业利益高度一致。相应的策略是由为患者提供基于需求的护理的共同目标驱动的。个别专业人士独立并代表团队工作。当各个团队成员代表其他专业团体筛选患者时，也存在一定程度的技能转移。结论：该研究确定了以患者为中心的护理的支持因素和背景。这凸显了通过专业参与改善卫生人力治理的能力，应在更广泛的医疗保健服务中更系统地探索这一点。
Background: Patient-centred care based on needs has been gaining momentum in health policy and the workforce. This creates new demand for interprofessional teams and redefining roles and tasks of professionals, yet little is known on how to implement new health policies more effectively. Our aim was to analyse the role and capacity of health professions in driving organisational change in interprofessional working and patient-centred care.Methods: A case study of the introduction of interprofessional, early discharge teams in stroke rehabilitation in Denmark was conducted with focus on day-to-day coordination of care tasks and the professional groups' interests and strategies. The study included 5 stroke teams and 17 interviews with different health professionals conducted in 2015.Results: Professional groups expressed highly positive professional interest in reorganised stroke rehabilitation concerning patients, professional practice and intersectoral relations; individual professional and collective interprofessional interests strongly coincided. The corresponding strategies were driven by a shared goal of providing needs-based care for patients. Individual professionals worked independently and on behalf of the team. There was also a degree of skills transfer as individual team members screened patients on behalf of other professional groups.Conclusions: The study identified supportive factors and contexts of patient-centred care. This highlights capacity to improve health workforce governance through professional participation, which should be explored more systematically in a wider range of healthcare services.