在六个癌症中心实施基于患者报告结果的电子症状管理计划的策略
Michael Hassett1, Samira Dias2, Christine Cronin2
1Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Ave, Boston, MA, 02215, USA. michael_hassett@dfci.harvard.edu.
BMC health services research
|November 13, 2024
概括
在癌症护理中实施电子患者报告结果 (ePRO) 需要结构化策略. 这项研究确定了通用,高影响力的战略,成功地将ePRO整合到常规临床实践中.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 实施科学 实施科学
背景情况:
- 电子患者报告结果 (ePROs) 提高了癌症患者的结果,但面临实施挑战.
- 这些挑战包括技术整合,利益相关者参与,工作流程调整和机构投资.
- SIMPRO研究联盟通过结构化实施计划解决了这些障碍.
研究的目的:
- 开发和部署电子健康记录集成的ePRO系统 (eSyM) 用于瘤和手术患者的症状管理.
- 系统地记录和分析多个癌症中心使用的实施策略.
- 确定有效的策略,以促进采用基于ePRO的干预措施.
主要方法:
- 一个II型混合有效性实施集群随机分级研究,涉及六个癌症中心.
- 在2019年8月至2022年4月期间部署eSyM计划.
- 使用REDCap实施策略的月度文档,根据实施变革专家建议 (ERIC) 列表进行分类,并映射到实施研究综合框架 (CFIR).
主要成果:
- 共有226个实施策略被记录下来,其中35个是基础策略和191个是现场开发的策略.
- 现场开发的策略被整合成64个独特的策略,分为29个"通用"和35个"适应性".
- 针对临床准备,培训和参与的通用策略被认为是最有影响力的,有44个ERIC策略和所有5个CFIR障碍被解决.
结论:
- 系统地收集基于理论的实施策略,确定通用,高影响力的方法.
- 这些策略促进了患者,临床医生和机构采用一种新的护理交付干预措施.
- 识别出的高影响力策略可以指导其他机构将ePRO实施到常规癌症护理中.
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