背景:社区卫生工作者(CHW)在医疗保健部门中的地位越来越高,然而,关于CHW的角色还没有明确的共识,目的,和卫生系统内的价值。这种缺乏共识有可能影响CHWs的感知方式,利用,并最终整合到医疗保健领域。本研究调查了目前使用CHW的临床护理团队,以(1)了解护理团队成员如何感知CHW的目的和价值,(2)考虑CHW的感知与医疗保健团队内的CHW整合如何相关。
方法:研究人员在伊利诺伊大学芝加哥分校的医院和健康科学系统(UIHealth)进行了一项定性的描述性多嵌入式案例研究。分析的嵌入式亚基是UIHealth中的团队,他们目前正在使用CHW来协助向患者提供临床护理或服务。数据是通过半结构化访谈和文件审查收集的。
结果:总计,6个子单位报名参加,对CHW进行了17次访谈(n=9),和管理员或医疗保健提供者(n=8)。受访者对CHW的报告看法不一致。CHWs的角色并不总是被理解,CHW的目的和价值被护理团队的不同成员不同地感知。此外,评估指标并不总是能捕捉到CHW对医疗保健系统的价值。在某些情况下,护理团队围绕CHW在护理团队中的角色和目的的共同理解更加一致。当人们对CHW的看法既积极又一致时,受访者报告说,医疗保健系统内的整合水平更高。
结论:护理团队对CHW角色的看法保持一致,目的,和卫生系统内的价值可以在医疗保健团队中CHW的整合中发挥重要作用。
BACKGROUND: Community health workers (CHW) have grown in prominence within the healthcare sector, yet there is no clear consensus regarding a CHW\'s role, purpose, and
value within health systems. This lack of consensus has the potential to affect how CHWs are perceived, utilized, and ultimately integrated within the healthcare sector. This research examines clinical care teams that currently employ CHWs to (1) understand how members of the care team perceive CHWs\' purpose and
value, and (2) consider how perceptions of CHWs are related to CHW integration within health care teams.
METHODS: Researchers conducted a qualitative descriptive multiple embedded
case study at the University of Illinois at Chicago\'s Hospital and Health Science System (UI Health). The embedded subunits of analysis were teams within UI Health that are currently employing CHWs to assist with the provision of clinical care or services to patients. Data were collected via semi-structured interviews and document review.
RESULTS: In total, 6 sub-units were enrolled to participate, and 17 interviews were conducted with CHWs (n = 9), and administrators or health care providers (n = 8). Reported perceptions of CHWs were inconsistent across respondents. CHWs roles were not always understood, and the CHW\'s purpose and
value was perceived differently by different members of the care team. Moreover, evaluation metrics did not always capture CHWs\'
value to the health care system. In some cases, care teams were more aligned around a shared understanding of the CHW\'s roles and purpose within the care team. When perceptions regarding CHWs were both positive and aligned, respondents reported higher levels of integration within the healthcare system.
CONCLUSIONS: Alignment in a care team\'s perception of a CHW\'s role, purpose, and value within the health system could play an important role in the integration of CHWs within healthcare teams.