Curriculum adaptations.

Shared medical appointments (SMA) help patients learn skills to self-manage chronic medical conditions. While this model of care delivery is thought to improve access to care with an efficient use of healthcare providers’ time, many healthcare teams struggle to implement this healthcare model. Guidance and training resources on the implementation of SMAs is expected to improve adoption, implementation and sustainability of SMAs. Our evaluation team collaborated with the HF SMA trainer to complete a developmental formative evaluation of a two-day training program with a goal of adapting the training program and to better suit the needs and resources of healthcare teams interested in implementing HF-SMAs. Our evaluation team interviewed members of healthcare teams participating during each stage of training: pre-training, post-training, and post-implementation. The evaluation team also observed training sessions and reviewed minutes from debrief and training team meetings. Qualitative data collected from interviews, observations and document reviews were analyzed using matrix analysis with a focus on identifying potential adaptations to improve the HF-SMA training program. Data summaries were presented by the evaluation team to the training team for consideration. Training program participants found the training comprehensive, useful, and helpful; they highlighted how the trainers were experienced SMA providers who shared lessons learned. While participants found the training to be useful, opportunities for improvement, success of the virtual format and identified six adaptations: 1) the two-day training was reduced to short online modules, 2) curriculum was adapted to fit local site’s needs, 3) added periodic one-on-one coaching, 4) shifted training to focus on skills and knowledge needed for each team member requirements, 5) adapted curriculum provides for more team building during premeeting assignments, and 6) training had more information included. We offer/present an improved model for a HF-SMA training program. Future studies, potentially using comparative designs to measure success and sustainability are needed.

共享医疗预约（Shared Medical Appointments, SMA）可帮助患者掌握慢性疾病自我管理的相关技能。尽管该诊疗服务模式被认为能够在高效利用医护人员时间的同时提升诊疗可及性，但诸多医护团队在落地该医疗模式时仍面临重重挑战。针对SMA落地的指导与培训资源，有望提升该模式的推广、实施与可持续性。本评估团队与HF-SMA培训师合作，针对一项为期两日的培训项目开展开发性形成性评估，旨在优化该培训方案，以更好地契合有意推广HF-SMA的医护团队的实际需求与可用资源。本评估团队对参与培训各阶段（培训前、培训后及实施后）的医护团队成员进行了访谈；此外，评估团队还观摩了培训课程，并复盘了培训复盘会与培训团队会议的会议纪要。研究采用矩阵分析法对访谈、观摩及文档审查所获取的质性数据进行分析，重点识别可用于优化HF-SMA培训方案的潜在改进方向。评估团队将数据总结提交给培训团队以供审议。培训项目参与者认为本次培训内容全面、实用性强且极具助益；他们特别提到，授课讲师均为经验丰富的SMA实践者，分享了诸多实操经验与教训。尽管参与者均认可本次培训的实用价值，但他们也指出了可优化之处、线上培训模式的优势，并总结出六项改进方向：1）将为期两日的培训拆解为若干短时长线上模块；2）调整课程内容以适配各本地医疗机构的实际需求；3）增设定期一对一指导环节；4）调整培训重点，使其贴合各团队成员岗位所需的技能与知识储备；5）优化课程设置，在会前任务中强化团队建设环节；6）补充更多相关培训内容。本研究提出了一款优化后的HF-SMA培训方案模型。未来可采用对比研究设计来评估该方案的实施效果与可持续性，相关研究仍有待开展。