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A systems-based partnership learning model for strengthening primary healthcare

机译：基于系统的伙伴关系学习模型，用于加强基础医疗保健

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Background Strengthening primary healthcare systems is vital to improving health outcomes and reducing inequity. However, there are few tools and models available in published literature showing how primary care system strengthening can be achieved on a large scale. Challenges to strengthening primary healthcare (PHC) systems include the dispersion, diversity and relative independence of primary care providers; the scope and complexity of PHC; limited infrastructure available to support population health approaches; and the generally poor and fragmented state of PHC information systems. Drawing on concepts of comprehensive PHC, integrated quality improvement (IQI) methods, system-based research networks, and system-based participatory action research, we describe a learning model for strengthening PHC that addresses these challenges. We describe the evolution of this model within the Australian Aboriginal and Torres Strait Islander primary healthcare context, successes and challenges in its application, and key issues for further research. Discussion IQI approaches combined with system-based participatory action research and system-based research networks offer potential to support program implementation and ongoing learning across a wide scope of primary healthcare practice and on a large scale. The Partnership Learning Model (PLM) can be seen as an integrated model for large-scale knowledge translation across the scope of priority aspects of PHC. With appropriate engagement of relevant stakeholders, the model may be applicable to a wide range of settings. In IQI, and in the PLM specifically, there is a clear role for research in contributing to refining and evaluating existing tools and processes, and in developing and trialling innovations. Achieving an appropriate balance between funding IQI activity as part of routine service delivery and funding IQI related research will be vital to developing and sustaining this type of PLM. Summary This paper draws together several different previously described concepts and extends the understanding of how PHC systems can be strengthened through systematic and partnership-based approaches. We describe a model developed from these concepts and its application in the Australian Indigenous primary healthcare context, and raise questions about sustainability and wider relevance of the model.
机译：背景加强初级卫生保健系统对于改善健康状况和减少不平等现象至关重要。但是，在已发表的文献中，很少有工具和模型可以显示出如何大规模地加强初级保健系统。加强初级保健（PHC）系统的挑战包括初级保健提供者的分散，多样性和相对独立性; PHC的范围和复杂性;可用于支持人口健康方法的基础设施有限;以及PHC信息系统普遍状况不佳和零散状态。借助综合PHC，集成质量改进（IQI）方法，基于系统的研究网络和基于系统的参与性行动研究的概念，我们描述了一种用于增强PHC的学习模型，以应对这些挑战。我们将在澳大利亚原住民和托雷斯海峡岛民主要医疗保健背景下描述该模型的演变，应用中的成功与挑战以及需要进一步研究的关键问题。讨论IQI方法与基于系统的参与式行动研究和基于系统的研究网络相结合，为在广泛的初级卫生保健实践中大规模支持计划实施和持续学习提供了潜力。伙伴关系学习模型（PLM）可被视为跨越PHC优先级范围的大规模知识转换的集成模型。在相关利益相关者的适当参与下，该模型可能适用于多种设置。在IQI中，尤其是在PLM中，研究在促进改进和评估现有工具和流程以及开发和试验创新方面发挥着明显作用。在作为日常服务提供一部分的IQI活动资助与IQI相关研究的资助之间取得适当的平衡，对于开发和维持这种PLM至关重要。总结本文总结了几个先前描述的概念，并扩展了对如何通过系统的，基于伙伴关系的方法来增强PHC系统的理解。我们描述了从这些概念发展而来的模型及其在澳大利亚土著初级卫生保健背景下的应用，并提出了有关模型的可持续性和更广泛相关性的问题。

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