使用理论,模型和框架来告知计算机化临床决策支持系统在三级医疗保健机构的实施周期:范围审查
Manasha Fernando1, Bridget Abell1, Zephanie Tyack1
1Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
Journal of medical Internet research
|October 18, 2023
概括
这次审查发现,模型和决定因素框架最常用于在医院实施计算机化临床决策支持系统 (CDSS). 然而,没有,有.
科学领域:
- 医疗信息学 医疗信息学
- 实施科学 实施科学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 计算机化临床决策支持系统 (CDSS) 对于现代医疗保健至关重要,特别是在医院.
- 理论,模型和框架可以帮助CDSS实施,涵盖诸如上下文评估,采用计划和评估等方面.
- 缺乏关于医院CDSS实施理论,模型和框架的文献综合.
研究的目的:
- 确定用于CDSS实施和采用在三级医疗机构中的理论,模型和框架.
- 描述选定的理论方法的理由,优点和局限性.
- 解决了解这些框架在医院CDSS实施中的应用方面的差距.
主要方法:
- 使用5个电子数据库 (CINAHL,PubMed,Scopus,PsycINFO,Embase) 进行了一个范围审查.
- 包括使用实施理论,模型或框架在第三级护理中实施或采用CDSS的研究.
- 一个叙事综合将实施阶段分类为使用"积极实施框架阶段".
主要成果:
- 包括81个记录,模型 (43%) 和决定因素框架 (33%) 是最常见的方法.
- 大多数研究 (86%) 没有报告应用理论,模型或框架的局限性.
- 模型经常被使用,但通常不会与完整周期实施的理论相结合.
结论:
- 在CDSS采用策略中,模型和质量改进方法普遍存在.
- 对于全周期医院CDSS实施的理论,模型和框架的全面应用存在显著的差距.
- 需要进一步的研究,以有效地整合这些方法,以便在医院中强有力的CDSS实施.
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