在第三级医疗保健系统中实施肝硬化顺序:以理论为基础的形成性评估
A M Hyde1, E Johnson1, T Luig2
1Division of Gastroenterology (Liver Unit), Faculty of Medicine & Dentistry, University of Alberta, 8540 112 St NW, Edmonton, AB, T6G 2P8, Canada.
BMC health services research
|June 14, 2023
概括
对肝硬化治疗实施标准化订单集可以改善患者的治疗结果. 医疗保健提供者发现了诸如倦怠和沟通缺口等挑战,强调需要资源和跨群体合作才能成功实施质量改进计划.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 临床实践指南 临床实践指南
- 实施科学 实施科学
背景情况:
- 标准化的订单组旨在提高对临床指南的遵守和患者护理质量的质量.
- 新的质量改进举措,如订单集,面临实施挑战.
- 在COVID-19之前进行了形成性评估,以评估医疗保健提供者对实施临床变革的观点.
研究的目的:
- 了解医疗保健提供者对实施临床变革的观点.
- 确定影响实施临床变化的个人,集体和组织因素.
- 使用实施科学框架探索对肝硬化顺序集的看法.
主要方法:
- 使用实施研究综合框架 (CFIR) 和规范化过程理论 (NPT).
- 进行了8个焦点小组,与54名医疗保健专业人员 (医生,护士,护士从业人员,社会工作者,药剂师,理疗师) 负责照顾肝硬化患者.
- 通过使用NPT和CFIR的相关构造,以演的方式编码数据.
主要成果:
- 参与者承认肝硬化顺序的价值和潜力,以提高护理质量.
- 确定的实施挑战包括竞争的质量倡议,供应商倦怠和沟通不良.
- 缺乏专门的实施资源也被强调为一个重要的障碍.
结论:
- 在不同临床群体和场所实施复杂的举措带来了挑战.
- 过去的实施经验对新的干预措施有很大的影响.
- 有效的沟通和充足的资源对于成功实施至关重要;理论镜头有助于预测挑战.
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