从一个多站点阶梯集群随机化家庭护理人员技能培训试验的实施结果
Courtney Harold Van Houtven1,2,3, Kasey Decosimo1, Connor Drake1,2
1Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina, USA.
Health services research
|August 9, 2024
概括
CONNECT团队协作战略并没有改善iHI-FIVES护理人员计划的实施. 仅仅复制有效计划 (REP) 显示出更高的覆盖范围和忠诚度,领导层的支持对成功至关重要.
科学领域:
- 实施科学 实施科学
- 医疗保健管理的管理
- 护理人员支持计划 护理人员支持计划
背景情况:
- 退伍军人事务部 (VA) 试图改善家庭护理人员技能培训 (iHI-FIVES).
- 评估团队协作策略对计划实施的影响对于改善医疗保健质量至关重要.
研究的目的:
- 评估CONNECT团队协作策略是否提高了iHI-FIVES家庭护理人员技能培训计划的实施结果.
- 为了比较团队协作策略 (CONNECT) 加上复制有效程序 (REP) 与单独的REP之间的实施结果.
主要方法:
- 一个阶梯集群随机试验在八个VA医疗中心进行.
- 通过使用电子健康记录,员工调查和采访来评估实施结果 (覆盖范围和忠实性).
- 这项研究比较了CONNECT手臂 (CONNECT + REP) 和非CONNECT手臂 (仅REP).
主要成果:
- 整体忠实度很高 (88%),但仅在REP手臂 (95%) 和CONNECT手臂 (80%) 相比,忠实度更高.
- 总体而言,程序覆盖率为18%,仅在REP手臂 (22%) 和CONNECT手臂 (14%) 中也更高.
- 定性数据表明,强大的领导支持与更高的覆盖率相关;CONNECT没有改善自我报告的团队功能.
结论:
- 将CONNECT策略添加到REP中并没有显著改善iHI-FIVES的覆盖范围或忠实性,并且需要更多的资源.
- 领导力支持成为成功实施的关键因素,可能是未来计划扩展的关键.
- 与CONNECT加上REP相比,单独的REP显示了可比或优越的实施结果.
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