Development and evaluation of the Rural and Northern Community Focused Model of COPD Care (RaNCoM)

BMC Pulmonary Medicine

Research

Christopher Ross¹  Kathy Marchal²  Anthon Meyer³  Shannon Freeman⁴  Kelly Skinner⁵  Laura Peach⁵ 

[1] Centre for Technology Adoption for Aging in the North, University of Northern British Columbia, Prince George, British Columbia, Canada;Fort St, James Health Centre, Fort St. James, British Columbia, Canada;Rural Coordination Centre of BC, British Columbia, Canada;School of Nursing, University of Northern British Columbia, British Columbia, 3333 University Way, V2N 4Z9, Prince George, Canada;Centre for Technology Adoption for Aging in the North, University of Northern British Columbia, Prince George, British Columbia, Canada;School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada;

关键词: Chronic obstructive pulmonary disease;    Primary care;    Rural;    Northern;    Model;    Process evaluation;   

DOI  :  10.1186/s12890-023-02683-2

 received in 2023-01-10, accepted in 2023-09-27,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe prevalence of COPD continues to rise. To address the challenges to provide high quality COPD care in rural and northern communities, leaders in one rural and northern community in Western Canada sought to change the culture of COPD screening and care. Recognizing effective assessment, diagnosis, and treatment for patients with COPD are crucial to improve outcomes, a program was developed between 2012 and 2021 to enhance primary care for COPD patients.MethodsA process evaluation was undertaken to assess program development, implementation, mechanisms of impact, and context of COPD program. Qualitative thematic analysis of stakeholder interviews (n = 11) and a document review (n = 60; ~ 500 pages) of key clinic documents was conducted.ResultsWe describe five phases of the COPD program’s development (Survive; Reorganize and Stabilize; Assess and Respond; Build and Refine; and Sustain and Share), highlighting areas of innovation. Outreach and localizing resources improved access to the program. Acquiring secured physician compensation, capturing quality data, and improving patient and provider self-efficacy built the capacity of the system and stakeholders within it. Finally, relationships were forged through building an integrated facility, collaborative networking, and patient engagement. Key elements of program implementation included the resources (infrastructure, software, operational) required to ensure operation.ConclusionTeam-based care and service integration enhanced care capacity and the health network. Focused use of infrastructure and resources supported the people in the care system. Upholding a shared value of relationship is critical to deliver robust and sustainable rural healthcare. Quality improvement requires investment in rural community healthcare resources.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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