在初级保健机构大规模质量改善举措的实施策略:质量评估
Debora Goetz Goldberg1, Constance Owens-Jasey2, Sahar Haghighat3
1Department of Health Administration and Policy, Affiliate Faculty, Center for Evidence-Based Behavioral Health, Department of Psychology, George Mason University, 4400 University Drive MS IJ3, Fairfax, VA, 22030, USA. dgoldbe4@gmu.edu.
初级保健实践从量身定制的实施策略中受益,以改善心血管保健质量. 解决倡议疲劳和考虑实践环境是成功采用基于证据的实践的关键.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 初级医疗保健医学 一级医疗保健医学
- 提高质量 提高科学 提高质量
背景情况:
- EvidenceNOW旨在加强美国初级保健机构的心血管保健.
- 该倡议的重点是实施基于证据的实践和建立质量改进能力.
- 这项研究探讨了参与者和研究小组对弗吉尼亚州EvidenceNOW倡议的观点.
研究的目的:
- 了解参与者和研究团队对实施策略的看法.
- 确定影响EvidenceNOW倡议成功的因素.
- 为未来的初级保健质量改善工作提供信息.
主要方法:
- 进行了25个重点小组,与80名临床医生和工作人员.
- 与研究小组成员进行了22次采访.
- 采用卫生服务研究实施综合促进行动 (i-PARIHS) 框架进行定性分析.
主要成果:
- 现场促进和专家顾问的互动是高度重视的实施策略.
- 领导层的支持,资源,先前的经验和实践所有权影响了质量改进.
- 临床医生和工作人员的"主动性疲劳"阻碍了充分参与.
结论:
- 实践环境对于在初级保健中实施基于证据的实践至关重要.
- 未来的质量改进举措必须是特定于环境的,并应对倡议疲劳.
- 外部支持可以增强初级保健实践的持续质量改善能力.
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