应用RE-AIM来检查实施便利化方案的影响,以扩大慢性阻塞性肺病退伍军人计划的规模
Edward C Portillo1,2, Martha A Maurer3, Jordyn T Kettner3,4
1School of Pharmacy, University of Wisconsin - Madison, 77 Highland Avenue, Madison, WI, 53705, USA. edward.portillo@wisc.edu.
通过COPD CARE学院的实施便利化显著提高了临床医生的能力,在美国退伍军人中提供基于证据的慢性阻塞性肺病 (COPD) 护理. 该计划提高了COPD管理的能力,改善了退伍军人的健康结果.
科学领域:
- 实施科学 实施科学
- 医疗保健管理的管理
- 肺部医学 肺部医学
背景情况:
- 与平民相比,美国退伍军人患慢性阻塞性肺病 (COPD) 的风险高出四倍.
- 现有的护理模式很难在规模上持续改善退伍军人的结果.
- 减少恶化的COPD协调访问 (CARE) 包旨在增强基于证据的COPD护理服务.
研究的目的:
- 评估COPD CARE学院 (学院),这是一个旨在扩大退伍军人卫生管理局 (VA) COPD CARE包的实施便利化方案.
- 评估学院实施战略对RE-AIM框架成果的影响.
- 确定学院在提高临床医生实施COPD CARE的感知能力方面的有效性.
主要方法:
- 采用调查和半结构面试的混合方法评估.
- 参与学院后进行的调查;8-12个月后进行的采访.
- 用描述性统计数据分析定量数据;用主题分析分析定性数据.
主要成果:
- 来自13个VA医疗中心 (VAMC) 的36名临床医生参加了这次活动;264名前线临床医生完成了COPD CARE培训.
- 高学院会议出席率 (90%) 和资源利用率 (92%的VAMC报告长期使用) 显示了强的采用.
- 临床医生报告说,在学院后,执行10项实施任务的能力显著增加 (p < 0.05).
结论:
- 通过COPD CARE学院提供的实施便利,成功增强了临床医生实施COPD CARE的能力.
- 该学院证明了作为实施战略的可接受性和适当性.
- 需要对学院后资源进行进一步的研究,以支持克服实施障碍的本地化战略.
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