Background: The multidisciplinary "Specialist Medical Outreach Project (SMOP)" was designed to improve care for high-risk residents in nursing homes in Macao. This study aimed to explore the experiences of SMOP and the key contextual determinants influencing SMOP outcomes. Design: This study contains 2 phases, a literature review to gain an understanding of existing research about medical outreach programs and provide background information for further study. A literature review was conducted in 4 databases with search terms: Outreach, Healthcare, Long term care, Nursing home in English and Chinese. Studies about health outreach in nursing home settings are included In phase 2 semi-structured interviews were conducted with NH personnel to exam their understanding of, attitudes to, and experiences with the SMOP. Purposive sample nursing home staff who had first-hand experiences with SMOP Results: The literature review identified 18 publications. The data concluded that the MOP provides a range of interventions, the most popular intervention is health assessment, education, and medication review. Rehabilitation is also a common purpose for a mop. The major outcomes are lower hospitalization rates and cost-effectiveness. However, some reports concern the program are resulting insignificant benefit Forty-nine interviews were conducted. Thematic analysis identified 3 principal themes: the overall perception about SMOP, the benefits as observed; and the areas of improvement. Together with the 10 subthemes, the results highlighted the expectations for SMOP to address the unmet needs and promote patient-centered care, and the benefits of SMOP in supporting the effective use of resources for the nursing home, reducing the risks of adverse events for the residents, promoting communication and capacity building for the healthcare providers, and facilitating efficient use of healthcare resources for the health system. Requests for more frequent visits by a larger multidisciplinary specialist team were raised. Careful staff and workflow planning, and mechanisms for data-sharing and communication across care settings were deemed the most important actions for improvement. Conclusion: SMOP is believed to enhance the quality of care for high-risk residents in the nursing home in Macao. Cross-sector multi-disciplinary collaboration and efficient data-sharing and communication mechanisms play a crucial role in ensuring the success of the program. A robust assessment framework to monitor and evaluate the cost-effectiveness of the program is yet to be developed. Keywords: Outreach; Nursing home; Long-term care, Qualitative study; Elderly Care; Interview

背景:多學科的“專科外展醫療服務計劃(SMOP)”旨在改善對澳門養老院高危居民的護理。本研究旨在探索 SMOP 的經驗和影響 SMOP 結果的關鍵背景決定因素。 研究設計:本研究包含 2個階段，文獻回顧以瞭解有關醫療外展計劃的現有研究，並為進一步研究提供背景信息。 在4個數據中進行了文獻檢索，檢索詞為:外展、醫療保健、長期護理、和養老院。包括了英文和中文的文獻。 納入的研究為關於安老院環境中的健康外展的研究 在第 2 階段，對關鍵持份者，安老院的工作人員進行了半結構化訪談，以檢查他們對 SMOP 的理解、態度和經驗。 目地抽樣法招募了有 SMOP 第一手經驗的安老院工作人員參與者:來自養老院的管理人员、醫生、護理人員和藥劑師。訪談內容經過轉錄後用主題分析法将内容進行分类，编碼。 結果:文獻回顧確定了 18 份研究。過分析總結，MOP 最常見的干預措施是健康評估、教育和藥物審查。康復治療也是 MOP 的常見目的。MOP 最常見的產出上是降低住院率和提高成本效益。 但與此同時，一些研究擔心对於外展服務的成效的並不明顯。訪談研究中本研究一共進行了 49 次訪談。通過主題分析，確定了3 個主要的主題:(1) 對 SMOP 的總體看法，(2)觀察到的好處以及(3)需要改進的地方。同時確認了 10 個次主題。研究結果強調了對 SMOP 的期望，以解決未滿足的需求和促進以病人為中心的護理，以及 SMOP 在支持養老院有效利用資源、減少住院者的不良事件風險、促進醫療服務提供者的溝通和能力建設以及促進衛生系統有效利用醫療資源方面的好處。部分参與者提出期望由更多的專科專家隊進行更频繁的訪問。同時，更详細的人員和工作流程规劃，以及跨護理的数據共享和溝通機制被認為是最重要的改進行動。 結論:SMOP 被認為可以提高澳門養老院高危住戶的護理質量。跨部門的多學科合作和有效的數據共享和溝通機制對確保該計劃的成功起到了關鍵作用。一個健全的評估框架來監测和評估該計劃的成本效益，還有待開發。 關鍵詞 外展;療養院;定性研究;長期護理機構;老年人護理;訪談