背景:国家卫生和社会护理标准很复杂,质量改进干预措施。标准通常描述安全的过程和/或结果,质量,根据最佳证据,以人为中心的护理。目前,有11个国家标准适用于爱尔兰的各种服务,包括住宅中心,急症医院、康复和社区住院医疗服务。在选择实施战略以加强标准的实施时,更好地了解影响实施的环境因素将为决策提供信息。
目的:探索实施国家卫生和社会保健标准的经验,确定与卫生系统多个层面的利益相关者实施的推动因素和障碍。
方法:定性描述性研究。
方法:我们在2021年10月至11月与系统级别的利益相关者进行了六个焦点小组和八个个人访谈(n=14),组织层面(n=14)和个人层面(n=10)。焦点小组和访谈被录音,逐字转录,并使用反身主题分析进行分析。
结果:产生了六个主题;(1)自上而下,自下而上,团队方法:每个人都在一起,我们都参与其中,我们都有责任,(2)支持工具:与标准相关的可访问工具和咬合尺寸材料将支持我们实施标准,(3)用知识赋予权力:提高对标准的认识和理解,让它们在实践中相互关联,这样我们就能理解它们,(4)全系统的不适:我们没有实施标准的带宽,(5)跟随领导:我们需要各级领导来激励执行,(6)双向影响:我们知道检查推动质量改进,但我们仍然对检查结果感到不安。
结论:确定的与团队合作相关的关键促成因素,支持工具,领导和检查。与劳动力问题相关的关键障碍,缺乏对标准的认识和对检查结果的恐惧。我们的发现可以纳入支持标准实施的战略,最终是为了服务用户的利益。
结论:本研究中描述的推动者和障碍反映了组织因素在实施标准中的重要性。跨学科团队可以从这些发现中推断,哪些推动者和障碍适用于他们自己的上下文。在选择可以有效支持标准实施的策略时,这些发现可以为决策提供信息。
■我们遵守了定性研究报告标准(SRQR)指南。
■没有患者或公众捐款。
BACKGROUND: National health and social care standards are complex, quality improvement interventions. Standards typically describe a process and/or outcome of safe, quality, person-centred care according to best evidence. Currently, there are 11 national standards that apply to diverse services in Ireland including residential centres, acute hospitals and rehabilitation and community inpatient healthcare services. A better understanding of contextual factors influencing implementation will inform decision-making when selecting implementation strategies to enhance the implementation of standards.
OBJECTIVE: To explore experiences of implementing national health and social care standards and secondly, to identify
enablers and barriers to implementation with stakeholders from across multiple levels of the health system.
METHODS: A qualitative descriptive study.
METHODS: We conducted six focus groups and eight individual interviews from October to November 2021 with stakeholders at system level (n = 14), organizational level (n = 14) and individual level (n = 10). Focus groups and interviews were audio-recorded, transcribed verbatim and analysed using reflexive thematic analysis.
RESULTS: Six themes were generated; (1) Top-down, bottom-up, a team approach: everybody together, we are all involved, we are all responsible, (2) Support tools: accessible tools and bite-size material pertaining to standards will support us to implement standards, (3) Empower with knowledge: increase awareness and understanding of standards, make them relatable in practice so we can make sense of them, (4) A system-wide malaise: we do not have the bandwidth to implement standards, (5) Follow the leader: we need a lead person at every level to inspire implementation, (6) A bi-directional influence: we know inspections drive quality improvements but we still feel trepidation around inspection outcomes.
CONCLUSIONS: Key
enablers identified related to teamwork, support tools, leadership and inspections. Key barriers related to workforce issues, a lack of awareness of standards and fear of inspection outcomes. Our findings can be incorporated into strategies to support implementation of standards, ultimately for the benefit of service-users.
CONCLUSIONS: The
enablers and barriers described in this study reflect the importance of organizational factors in the implementation of standards. Interdisciplinary teams can infer from these findings, which
enablers and barriers apply to their own context. These findings can inform decision-making when selecting strategies that can be effective in supporting the implementation of standards.
UNASSIGNED: We have adhered to the Standards for Reporting Qualitative Research (SRQR) guidelines.
UNASSIGNED: No patient or public contribution.