Lessons learned from England's Health Checks Programme: using qualitative research to identify and share best practice
Lessons learned from England's Health Checks Programme: using qualitative research to identify and share best practice
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DOI：
10.1186/s12875-015-0365-z
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发表时间：
2015-10-20
影响因子：
2.9
通讯作者：
Kelly, Shona
中科院分区：
文献类型：
--
作者：
Ismail, Hanif;Kelly, Shona
背景：本研究旨在探讨参与提供国家卫生服务 (NHS) 健康检查的工作人员所面临的挑战和障碍，这是一项初级保健中的系统性心血管疾病 (CVD) 风险评估和管理计划。 方法：数据来源于在 25 个全科医疗机构中进行的三项定性评估，并对涉及提供健康检查的所有级别的 58 名工作人员进行了深度访谈。使用框架方法对数据进行分析，并在研究和实践考虑的背景下报告结果。结果：结果表明，尽管确定了成功因素，但没有“一刀切”的蓝图来最大限度地提高吸收率：随着时间的推移，该计划的演变，以适应当地的需求，以适应患者群体的特殊特征；员工个人特点，如主动、热情、责任心强；一个支持团队。培训被明确确定为需要解决的领域，从业者将受益于 CVD 特定基线培训和进修课程，以使他们了解该领域的最新发展。然而，还有其他外部因素影响个人提供有效服务的能力，其中一些因素超出了个人的控制范围，包括转诊服务的削减、诊所空间不足或患者对健康检查的普遍认识。结论：参与本研究的从业者的日常经验表明，总体而言，健康检查被认为是一项值得进行的活动。但是，需要解决组织和结构性障碍。我们还建议建立明确的转诊途径，以便工作人员可以将患者转介到适当的服务（健康饮食课程、戒烟和运动转诊）。地方当局需要支持能够实现数据共享和链接的举措，以便在患者接受社会服务机构开展的戒烟或减少酒精危害计划等服务时，全科医生诊所能够得到通知。
Background: This study aimed to explore the challenges and barriers faced by staff involved in the delivery of the National Health Service (NHS) Health Check, a systematic cardiovascular disease (CVD) risk assessment and management program in primary care.Methods: Data have been derived from three qualitative evaluations that were conducted in 25 General Practices and involved in depth interviews with 58 staff involved all levels of the delivery of the Health Checks. Analysis of the data was undertaken using the framework approach and findings are reported within the context of research and practice considerations.Results: Findings indicated that there is no 'one size fits all' blueprint for maximising uptake although success factors were identified: evolution of the programme over time in response to local needs to suit the particular characteristics of the patient population; individual staff characteristics such as being proactive, enthusiastic and having specific responsibility; a supportive team. Training was clearly identified as an area that needed addressing and practitioners would benefit from CVD specific baseline training and refresher courses to keep them up to date with recent developments in the area. However there were other external factors that impinged on an individual's ability to provide an effective service, some of these were outside the control of individuals and included cutbacks in referral services, insufficient space to run clinics or general awareness of the Health Checks amongst patients.Conclusions: The everyday experiences of practitioners who participated in this study suggest that overall, Health Check is perceived as a worthwhile exercise. But, organisational and structural barriers need to be addressed. We also recommend that clear referral pathways be in place so staff can refer patients to appropriate services (healthy eating sessions, smoking cessation, and exercise referrals). Local authorities need to support initiatives that enable data sharing and linkage so that GP Practices are informed when patients take up services such as smoking cessation or alcohol harm reduction programmes run by social services.