Zhongguo quanke yixue (Sep 2022)
The Construction of an Evaluation Index System for Operation of Fever Alertness Clinics Based on Grounded Theory
Abstract
Background In March 2020, the Shanghai Municipal Health Commission proposed that fever alertness clinics should be set up in primary healthcare institutions (community health service centers) to deal with multi-site sporadic outbreaks by the principle of local emergency disposal combined with standardized and regular outbreak control. Objective To explore and construct a comprehensive and standardized evaluation index system for the operation of fever alertness clinics. Methods Two rounds of semi-structured in-depth interviews were conducted with 10 staff from three fever alertness clinics in downtown, suburban, and peri urban locations of Shanghai, respectively, using a purposive sampling method from January to April 2021. Raw data were obtained, interview materials were collated with the aid of the ROST CM6 software, and paradigm analyses were conducted using the Charmaz constructing grounded theory. Using a purposive sampling method, 12 experts familiar with the operating characteristics of fever alertness clinics (fever alertness clinics managers, researchers from universities, scholars from related associations, health development institutes, etc.) were invited as consulting objects to answer the correspondence questionnaire for 2 rounds from May to June 2021, and the weighting of indicators at each level was determined by hierarchical analysis to check the logical consistency of indicators at all levels, the evaluation index system of operation of fever alertness clinics was finally formed. Results The evaluation index system for operation of fever alertness clinics, which was constructed based on the grounded theory, consisted of 5 primary indicators, 13 secondary indicators and 29 tertiary indicators. The effective recoveries rate of the two rounds of expert consultation questionnaires was 100.0%, the expert authority coefficient of the two rounds was all 0.81, Kendall's W coefficients were 0.265 (χ2=163.768, P<0.001) and 0.320 (χ2=130.323, P<0.001) , respectively. The final developed evaluation index system for operation of fever alertness clinics consisted of 5 primary indexes (functions and responsibilities, consulting room setting requirements, staffing, workflow and work specifications) , 13 secondary indexes and 25 tertiary indexes. The weights of the five primary indexes were 0.033 7, 0.056 4, 0.392 6, 0.377 8 and 0.139 5, respectively. The consistency ratio (CR) of indicators at all levels was 0.056 5、0.032 5、0.042 4 (<0.100 0) . Conclusion The application of grounded theory to the construction of evaluation index system for fever alertness clinics is highly operable, and the constructed evaluation index system has a certain scientific validity and application value. Follow up with the policy iterations, the evaluation index system can be further supplemented and improved with the aid of grounded theory.
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