解决诊断差异问题的解决方案类型学:差距和机会
Vadim Dukhanin1, Aaron A Wiegand2,3, Taharat Sheikh2
1Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
解决诊断差异需要量身定制的解决方案. 这项研究对21种解决方案进行了分类,突出了实施差距和协作和患者参与等诊断卓越的推动因素.
科学领域:
- 医疗保健的质量和安全.
- 卫生公平性健康公平性
- 减少诊断错误的减少
背景情况:
- 诊断差异代表了诊断错误的可预防差异.
- 迫切需要确定和组织具体解决这些差异的解决方案.
- 现有的解决方案往往没有明确考虑诊断差异.
研究的目的:
- 描述诊断差异的潜在解决方案.
- 将这些解决方案组织成一个以行动为导向的类型学,并提供示例.
- 描述解决方案和确定发展差距.
主要方法:
- 进行了四个以人为中心的设计研讨会,拥有各种专业知识.
- 利用环境文献扫描来告知解决方案的构想.
- 通过19个半结构面试验验证解决方案和精细的类型学.
主要成果:
- 开发了21个解决方案的类型学,涵盖四个专业类别:医疗保健系统,教育工作者,患者安全研究人员和健康IT.
- 根据重点分类解决方案:6个是关于差异,5个是关于诊断,10个是关于一般医疗保健.
- 发现大多数解决方案的实施有限 (3广泛,12有限,6假设),在常规实践中发现了差距.
结论:
- 对诊断差异的现有解决方案进行调整和实施,存在重大机会.
- 推动进步的关键因素包括新的视角,强有力的证据,跨学科合作,系统重新设计,患者参与和联盟.
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