在研究中实施实践促进:促进者如何花费时间指导实践,以改善血压控制
Kent F Sutton1,2, Erica L Richman3, Jennifer R Rees4
1University of North Carolina at Chapel Hill, Cecil G. Sheps Center for Health Services Research, Chapel Hill, NC, USA. kfsutton@email.unc.edu.
Implementation science communications
|July 31, 2023
概括
实践促进者 (PF) 花费大量时间开车到农村实践中进行质量改进计划. 优化现场与远程通信对有效的高血压控制工作至关重要.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 提高质量 提高科学 提高质量
- 初级保健实践转型的转变
背景情况:
- 实践促进者 (PF) 是医疗保健质量改善 (QI) 计划的关键.
- 很少有研究量化了PF为支持实践所花费的时间.
- 本研究分析了农村高血压控制中的PF时间分配.
研究的目的:
- 分析实践辅导员在为期12个月的质量改善干预期间所花费的时间.
- 了解PF时间在不同活动 (驾驶,现场,远程) 中的分布.
- 探索实践特征和PFs花费的时间之间的相关性.
主要方法:
- 利用了来自东南合作改善血压控制 (SEC) 试验的数据,该试验涉及32个初级保健实践.
- 四名经过认证的PF记录了驾驶,现场工作和远程通信所花费的时间.
- 进行了描述性统计和相关性分析.
主要成果:
- 每次访问,PF员工平均花费130分钟开车,87分钟在现场,17分钟用于远程通信.
- 大多数PF时间都与临床工作人员和实践经理共度,而不是直接与初级保健提供者共度.
- 在花费时间和实践特征 (如付款人组合或FQHC状态) 之间没有发现显著的相关性.
结论:
- 实践辅导员花费大量时间旅行,强调需要平衡现场和远程参与.
- 互动模式显示,PF主要与临床工作人员和管理人员进行互动,与直接提供者联系有限.
- 研究结果为在农村初级保健机构设计有效的便利化模型提供了洞察力.
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