Related Experiment Videos
[Combined quantitative and qualitative methods to identify local facilitators of and barriers to physician's
F Saillour-Glénisson1, S Domecq, M-L Pouchadon
1CCECQA, hôpital Xavier-Arnozan, 33604 Pessac cedex, France. florence.saillour@ccecqa.asso.fr
Background:
The effectiveness of Clinical Practice Guideline (CPG) implementation interventions could be improved by their adaptation to facilitators of and barriers to practice change in each setting. Very few is known about these local factors in French hospitals. Our objectives were to identify the facilitator factors of and barriers to physician's adherence to CPG in internal medicine wards in France and to determine the factors most strongly statistically associated to CPG adherence.
Methods:
Combined qualitative and quantitative methods. Two CPGs were chosen as examples. The settings were internal medicine wards of hospitals of the Aquitaine region voluntary to participate. Qualitative analyses were conducted in the internal medicine wards of 5 hospitals in the Aquitaine region selected among the 12 voluntary hospitals to represent the variability of situations. QUANTITATIVE ANALYSIS: A questionnaire was constituted by the factors retrieved through the qualitative analyses and a previous literature review as barriers or facilitator factors to physician's adherence to CPG and asked the physicians on the degree of CPG adherence. It was sent to each physician of the internal medicine wards of the 12 voluntary hospitals. The responses to the questionnaire allowed the analysis of the frequency of each factor and the strength of the statistical association between these factors and CPG adherence.
Results:
These analyses focused on the importance of the management, particularly the role of ward head and of the exchange between physicians. The attitude to CPGs varied according to the individual positionnement on the professional hierarchy, function of the quantity of research activities and of the local, regional and national radiance of the ward. Organisational difficulties as professionals and patients turn over, work overload, lack of coordination between wards were organisational barriers to CPG adherence. The quantitative analysis confirmed the role of managerial and organisational factors in the CPG adherence.
Conclusion:
Following step was to validate a tool of barriers to CPG adherence identification and to study the effectiveness of this a priori identification in improving CPG adherence.
Related Concept Videos
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic illness...
01:26Methods of Documentation IV: Focus Charting
It typically involves three columns for recording information:
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...
01:23Methods of Documentation V: CBE
In CBE, healthcare professionals establish predefined standards of practice that define what constitutes...
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
01:05Data Collection III
The principles to begin the physical assessment include conducting a comprehensive or problem-related history in a quiet, well-lit room, emphasizing privacy and comfort for the patient.