摘要
背景为实现区域医联体内分级诊疗工作,如何让全科医师与专科医师的医疗行为进行有效的协同一直是研究的难点,如何运用岗位胜任力评估也一直是研究的重点,本研究通过运用可信赖式专业活动(EPAs)进行探索也是国内首创。目的为了缓解人民日益增长的就医需求与医疗资源的稀缺所产生的矛盾,同时为了更好地发挥三级医院的医疗资源的辐射效应,探索三级医院通过医联体制度将医疗资源纵向传导至社区的方法。方法上海交通大学医学院附属瑞金医院北院在2018年开发分级诊疗信息平台,包含4个模块:转诊管理、联合病床、转诊随访、信息查询等功能,基于这个系统产生的数据探索针对三级医院专科医师与基层社区医院全科医师实施有效黏合度培训,同时引入国外岗位胜任力理论和EPAs。基于医联体全科医师与专科医师分级诊疗的协作行为培训,问卷主体由三部分组成:人口统计学的相关信息、〔儿科全科医师、儿科(消化)专科医师〕EPAs指标、岗位胜任力指标,于2018年8-11月依托问卷星软件随机发放问卷,共收集问卷1476份。探索儿科全科医师与儿科专科医师的黏合度模型。结果儿科全科医师EPAs与儿科专科医师EPAs呈正相关(P<0.05);儿科全科医师胜任力与儿科专科医师胜任力呈正相关(P<0.05)。结论三级医院构建区域医联体建设,基于信息技术搭建业务平台(基于全生命周期电子健康综合档案、医技预约、联合病床整合平台),同时结合业务数据引入EPAs-胜任力,促进全科医师与专科医师的共通医疗行为协作集合,通过EPAs-胜任力理论探索全科-专科医师医联体内靶点培训项目。
Background During the implementation of hierarchical diagnosis and treatment in a regional medical consortium,how to effectively coordinate the medical behaviors of general practitioners(GPs)and specialists has always been a difficulty,and how to use post competency assessment has always been the focus of current research.We used entrustable professional activities(EPAs)to try to address the difficulty,which is a first attempt in China.Objective To explore ways to vertically allocate medical resources from the tertiary hospital to the community hospital in a regional consortium,to alleviate the contradiction between increasing healthcare needs of the people and insufficient medical resources,and to make tertiary hospitals to better play their radiation role in sharing their resources.Methods Ruijin Hospital(North),Shanghai Jiaotong University School of Medicine,developed a questionnaire in 2018,which consists of demographic information,EPAs evaluation indicators,and position competencies indicators for pediatric GPs and GI specialists,using introduced overseas theories of EPAs and position competencies,and data from the hierarchical diagnosis and treatment platform〔composed of 4 modules(referral management,combined use of hospital beds,follow-up services for referrals,information inquiry)〕constructed by this hospital in 2018.Then,Ruijin Hospital(North)conducted an online survey concerning cooperation between GPs and specialists in a regional medical consortium based on the www.wjx.cn platform by randomly posting the electronic version of the questionnaire to email addresses of pediatric GPs and GI specialists.A total of 1476 cases returned responsive questionnaires.The survey results were used to construct a cooperative training model,and to evaluate the general-specialist physician correlations in terms of EPAs and position competencies scores,and to test the model's reliability.Results The mean evaluation scores of EPAs indicators for pediatric GPs showed prominent positive correlation with those of pediatr
作者
高深甚
顾诗皓
何奕
汪新
杨晖
赵任
GAO Shenshen;GU Shihao;HE Yi;WANG Xin;YANG Hui;ZHAO Ren(Department of Human Resource,Ruijin Hospital(North),Shanghai Jiaotong University School of Medicine,Shanghai 201801,China;Department of Information Center,Ruijin Hospital(North),Shanghai Jiaotong University School of Medicine,Shanghai 201801,China;Department of Medical Administration,Ruijin Hospital(North),Shanghai Jiaotong University School of Medicine,Shanghai 201801,China;Department of Dean Office,Ruijin Hospital(North),Shanghai Jiaotong University School of Medicine,Shanghai 201801,China)
出处
《中国全科医学》
CAS
北大核心
2020年第13期1632-1639,共8页
Chinese General Practice
关键词
医联体
分级诊疗系统
医教协同
可信赖式专业活动
岗位胜任力
培养模型
Medical consortium
Tiered patient management system
Medicine-education synergy
Entrustable professional activities
Position competency
Training model
