背景:近年来,人们越来越重视患者体验,将其作为医疗保健质量的一个维度,并随后推动从患者的角度理解护理。患者阴影是一种已用于服务改善项目的方法,但其作为质量改进(QI)方法的潜力尚未在实际和可复制的细节中进行研究。
目的:这项新研究旨在为未来的质量改进项目提供明确的患者阴影指导。
方法:对英国国家QI计划的20名临床和非临床参与者进行了定性访谈,专注于改善患者在生命结束时的体验。所有参与者都有阴影患者。使用专题分析对数据进行了分析。
结果:有两个广泛的主题:(i)阴影过程:参与者如何进行阴影,采取不同的方法,并对他们观察到的护理和他们遇到的任何挑战做出判断。(ii)阴影的影响:对阴影者的参与和动机以及在服务变化方面使患者及其家人受益。
结论:这些发现导致了一套新的“金标准”原则,使阴影用作QI方法的工作人员和患者都受益。这些,加上新的指导,将确保阴影作为团队练习进行,所有参与的人都有更强有力的准备和支持,其作为改善患者体验的方法的目的将得到更好的理解。
BACKGROUND: In recent years, there has been an increased emphasis on patient experience as a dimension of quality in healthcare and subsequently a drive to understand care from the patient\'s perspective. Patient shadowing is an approach that has been used in service improvement projects, but its potential as a quality improvement (QI) method has not been studied in practical and replicable detail.
OBJECTIVE: This new research aimed to produce clear guidance on patient shadowing for future Quality Improvement projects.
METHODS: Qualitative interviews were conducted with 20 clinical and non-clinical participants of a national QI programme in UK, which focused on improving the experience of patients at the end of life. All participants had shadowed patients. Data were analysed using a thematic analysis.
RESULTS: There were two broad themes: (i) The process of shadowing: how participants went about shadowing, adopting different approaches and making judgements about the care they observed and any challenges they had encountered. (ii) The impact of shadowing: on the engagement and motivation of those who shadowed and in terms of service changes to benefit patients and their families.
CONCLUSIONS: The findings led to a new set of \'gold standard\' principles to benefit both staff and patients where shadowing is used as a QI method. These, together with new guidance, will ensure that shadowing is conducted as a team exercise, that all those involved are more robustly prepared and supported and that its purpose as a method to improve patient experience will be better understood.