初级保健提供者实施低剂量计算机断层扫描的经验 肺癌查的建议
Sara E Golden1, Jessica J Currier2, NithyaPriya Ramalingam2
1From the Center to Improve Veteran Involvement in Care, VA Portland Health Care System; Portland, OR (SFG, CGS), Division of Oncological Sciences, Oregon Health & Science University (OHSU); Portland, OR (JC, JS), Oregon Rural Practice-based Research Network, OHSU; Portland, OR, (NPR, MP, MMD), Department of Family Medicine, OHSU; Portland, OR (MMD), OHSU-PSU School of Public Health, OHSU; Portland, OR (MMD), Division of Pulmonary, Allergy, & Critical Care Medicine, OHSU; Portland, OR (CGS), Section of Pulmonary & Critical Care Medicine, VA Portland Health Care System; Portland, OR (CGS). sara.golden1@va.gov.
农村地区的初级保健提供者 (PCP) 支持肺癌查,但面临工作流和患者访问障碍. 实施查需要改善临床流程和专注的员工支持,以获得更好的患者结果.
科学领域:
- 实施科学 实施科学
- 农村卫生 农村卫生
- 在瘤学瘤学.
背景情况:
- 肺癌查对于早期检测和改善生存率至关重要.
- 农村初级保健机构在实施新的卫生计划方面面临着独特的挑战.
- 了解障碍物和促进因素是成功采用计划的关键.
研究的目的:
- 为初级保健提供者 (PCP) 确定在农村环境中实施肺癌查计划的障碍和促进者.
- 为提高肺癌查在服务不足地区的普及率制定策略.
主要方法:
- 与15名俄勒冈州12个农村医疗保健系统的15名PCP进行了定性访谈.
- 基于实施研究综合框架 (CFIR) 的分析指导.
- 采用了诱导和演的分析方法.
主要成果:
- PCP缺乏标准化的工作流程,用于肺癌查讨论,依赖患者病史和记忆.
- 患者层面的障碍包括对查扫描的地理准入和自付费用.
- 指定"冠军"和诊所工作人员的支持被确定为计划采用的关键促进者.
结论:
- 农村PCP支持肺癌查,但需要加强临床工作流程和流程.
- 解决与患者相关的障碍,如访问和成本,对于成功实施至关重要.
- 指定工作人员来管理转诊,查和后续护理,可以优化农村初级保健中的肺癌查计划.
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