实施增强恢复途径:对那些区分高绩效医院的因素的定性研究
Christina T Yuan1,2, JunBo Wu1, Chelsea P Cardell3
1Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD.
Annals of surgery
|December 5, 2023
概括
成功实施增强恢复途径需要有效的信息共享,规划和参与. 积极的临床医生信念和强有力的领导支持是改善遵守这些外科护理协议的关键.
科学领域:
- 医疗保健管理的管理
- 实施科学 实施科学
- 在外科手术期间的医学.
背景情况:
- 增强恢复途径 (ERP) 在临床上是有效的,但表现出不同的实施成功.
- 了解区分高和低ERP实施的因素至关重要.
研究的目的:
- 探索影响ERP实施的障碍和促进因素.
- 确定那些实施成功率更高的医院的区别因素.
主要方法:
- 与8家美国医院的168名外科领导人和工作人员进行了深入采访.
- 以"实施研究综合框架"为指导的专题分析.
- 基于随着时间的推移遵守9个流程措施的实施成功的评估.
主要成果:
- 积极因素:信息共享,规划和参与. 负面因素:路径的复杂性,基础设施和执行 (特别是电子健康记录的更改).
- 高绩效的医院具有积极的临床医生知识/信念和强有力的领导支持.
- 临床医生的参与和高管的支持对成功至关重要.
结论:
- 定性见解揭示了与成功实施ERP相关的关键因素.
- 不同的外科外科视角强调了沟通和领导的重要性.
- 解决途径复杂性和基础设施挑战对于广泛采用至关重要.
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