将CFIR-ERIC匹配工具的建议与现实世界的战略有效性数据进行比较:退伍军人卫生管理局的一项混合方法研究
Vera Yakovchenko1, Carolyn Lamorte1, Matthew J Chinman1,2,3
1Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, University Drive C (151C), Building 30, Pittsburgh, PA, 15240-1001, USA.
Implementation science : IS
|October 12, 2023
概括
这项研究发现,使用实施研究综合框架 (CFIR) - 实施变革专家建议 (ERIC) 工具识别的专家推的实施策略,在改善肝硬化护理方面比经常使用的策略更有效. 工具 工具 的工具.
科学领域:
- 实施科学 实施科学
- 改善医疗保健质量 改善医疗保健质量
- 医疗服务研究 医疗服务研究
背景情况:
- 为了使实施策略与干预障碍相匹配,缺乏实际方法.
- 这项研究评估了退伍军人卫生局国家学习协作中使用的策略,以改善符合指南的肝硬化护理.
研究的目的:
- 通过实施研究综合框架 (CFIR) 确定肝硬化护理的障碍.
- 使用CFIR-专家推实施变革 (ERIC) 工具生成和评估推的实施策略.
- 为了比较实际与推策略的使用和有效性.
主要方法:
- 融合平行混合方法研究,涉及与提供商的焦点小组和两年来的调查.
- 使用CFIR识别障碍,使用CFIR-ERIC匹配工具生成策略,并对95个VA站点的197个提供商进行了战略使用和有效性的调查.
- 将实际使用的策略与推的策略进行比较,并反向应用CFIR-ERIC工具来评估障碍策略对齐.
主要成果:
- 在CFIR-ERIC匹配工具推的策略,如评估准备,促进适应能力,并利用冠军和论领袖.
- 推策略的实际使用并不比其他策略更频繁,但70%的推策略与改善肝硬化护理有显著的关联.
- 反向匹配表明,经常使用的策略解决了诸如意见领袖,知识获取,资源,冠军和准备实施等障碍.
结论:
- 本研究提供了关于推和实际实施策略之间的关系的经验证据,支持障碍识别和专家信息的CFIR-ERIC工具的有效性.
- 推策略显示,与有效性比使用频率更密切的联系,突出了该工具在现实世界医疗保健改进工作中的实用性.
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