背景:人们越来越担心医疗劳动力的减少,人口变化加剧了,需要创新的解决方案。一种可行的方法涉及实施新的专业角色和重组医院护理单位内的现有医疗团队。
目标:为了评估创新任务转移概念的实施情况,护理相关服务(CRS),从瑞典某地区医院的躯体护理单位的管理者角度来看。
方法:定性研究于2022年实施CRS后进行。与24个主要利益攸关方进行了单独访谈,包括14名护理单位经理,六个CRS经理,和四个流程经理。进行了定性内容分析,利用实施研究的综合框架(CFIR)。
结果:CRS的实施涉及护理单元经理之间的协作,CRS经理,和项目经理,与CRS工作人员一起,注册护士(RN)和持牌职业护士(LVNs)。特别是,他们的角色包括定义边界,建立例程,和管理人员。在整个实施过程中,挑战出现了,源于未定义的目标,招聘合格的CRS员工有困难,以及与将CRS无缝集成到现有工作例程中相关的问题。这些挑战是由于有限的时间框架而产生的,广泛的团队忧虑,CRS员工培训中的缺点,任务分配不清,和增加护理单位管理人员的工作量。与成功实施CRS相关的因素包括管理人员之间的有效合作和开放的态度。
结论:我们的发现强调了清晰沟通的关键作用,有效招聘,整合CRS工作人员,角色的澄清,责任,并为成功实施CRS定义了目标。
BACKGROUND: The growing concern about a dwindling healthcare workforce, exacerbated by demographic changes, calls for innovative solutions. One viable approach involves implementing new professional roles and restructuring existing healthcare teams within hospital care units.
OBJECTIVE: To evaluate the implementation of an innovative task-shifting concept, care-related services (CRS), from the managers\' perspective in somatic care units across the hospitals in a region in Sweden.
METHODS: The qualitative study was conducted in 2022, after the implementation of CRS. Individual interviews were conducted with 24 key stakeholders, including 14 care unit managers, six CRS managers, and four process managers. A qualitative content analysis was performed, utilizing the Consolidated Framework of Implementation Research (CFIR).
RESULTS: The implementation of CRS involved collaboration between care unit managers, CRS managers, and project managers, alongside CRS staff, registered nurses (RNs), and licensed vocational nurses (LVNs). In particular, their roles encompassed defining boundaries, establishing routines, and managing personnel. Throughout the implementation process, challenges emerged, stemming from undefined goals, difficulties in recruiting qualified CRS staff, and issues associated with seamlessly integrating CRS into existing work routines. These challenges arose due to a constrained timeframe, widespread team apprehension, shortcomings in the training of CRS staff, unclear task allocation, and an increased workload for care unit managers. Factors associated with successful CRS implementation included effective cooperation among managers and an open-minded approach.
CONCLUSIONS: Our findings highlight the crucial role of clear communication, effective recruitment, integration of CRS staff, clarification of roles, responsibilities, and defined goals for successful CRS implementation.