准则组织在全国准则实施中的作用:定性研究
Andrea C Thoonsen1, Hanneke Merten2, Toby T Broeders2
1Amsterdam UMC, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, The Netherlands. a.thoonsen@amsterdamumc.nl.
荷兰的指南组织经常使用基本传播,而不是定制的实施计划. 监测和评估有限,导致对改善患者护理和结果的不确定性.
科学领域:
- 医疗保健管理的管理
- 临床实践指南 临床实践指南
- 实施科学 实施科学
背景情况:
- 在荷兰医疗保健中注意到非最佳临床实践指南 (CPG) 的采用和影响.
- CPG组织在CPG传播和实施方面发挥着至关重要的作用.
- 本研究探讨了这些组织如何规划,执行,监控和评估CPG传播和实施.
研究的目的:
- 探索荷兰指南组织对CPG传播和实施的规划,执行,监测和评估.
- 确定目前的实践和CPG实施战略的潜在改进领域.
主要方法:
- 定性研究设计. 定性研究设计.
- 与来自24个指导组织的35名参与者进行了半结构化采访.
- 使用实施规划理论,战略分类学和逻辑模型进行框架分析.
主要成果:
- 有限地使用先进的实施规划方法 (例如,障碍物识别,利益相关者参与,理论应用).
- 主要依赖于标准的,实用的传播策略 (例如分发,广告,演示).
- 执行过程,结果和影响的不频繁和基本的监测和评估.
结论:
- 尽管认识到实施的重要性,但行动并没有得到一致的定制.
- 大多数组织缺乏综合的,结构性的实施计划.
- 监测和评估的不足阻碍了对有效性的评估和改善患者结果的改善.
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