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两个促进策略的集群随机化实施试验,在退伍军人卫生管理局实施一种新的信息和通信技术

Chelsea Leonard^1,2,3, Evan Carey^4,5,6, Ariel Holstein^4,5

¹Denver-Seattle Center of Innovation for Veteran-Centered & Value-Driven Care (COIN), VA Eastern Colorado Healthcare System, Aurora, CO, 80045, USA. Chelsea.Leonard@va.gov.

Implementation science : IS

|January 3, 2024

概括

加强的便利化策略显著改善了对假肢护理的FLOW3系统的采用和使用. 虽然最初的实施显示了好处,但需要进一步的研究来了解长期可持续性.

科学领域:

医疗信息学医疗信息学
医疗保健管理的管理
假肢和整形手术

背景情况:

信息和通信技术 (ICT) 可以提高医疗保健的质量和效率.
对于医疗保健中的新信息通信技术的有效实施策略在很大程度上是未知的.
退伍军人卫生管理局 (VHA) 从2019年到2021年实施了FLOW3,一种用于假肢护理的ICT,从2019年到2021年.

研究的目的:

为了比较两个促进策略对FLOW3 ICT的采用,实施和维持的影响.
在现实世界医疗保健环境中,评估基本与增强便利化的有效性.

主要方法:

60个VHA站点被随机分为基本或增强的促进组,用于FLOW3实施.
基本的便利包括培训工具包和办公时间.
增强的促进包括基本组件,以及每月的学习协作和特定地点的绩效报告.

主要成果:

强化便利化的网站在实施过程中更有可能完全利用FLOW3 (ITT分析).
剂量反应分析表明,增强组的可能性是采用FLOW3.32的2.32倍.
所有地点在维持期间都提高了完成率,但两组之间的差异在统计学上并不显著.

结论:

加强促进,包括学习协作和反,增加了使用FLOW3.3完成假肢咨询的可能性.
在实施阶段观察到采用和利用的统计学上显著差异.
需要进一步调查,以了解这些促进策略的可持续性.

关键词:

促成便利化促成便利化实施实施实施信息和通信技术信息和通信技术

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