克服惯性:在手术前测试中提供对退出实施策略的观点
Erin Kim1, Alexis G Antunez2, Devak Nanua1
1University of Michigan Medical School, Ann Arbor, MI, USA.
American journal of surgery
|February 4, 2025
概括
撤销策略有效地减少了不必要的手术前测试,教育会议被证明是最有影响力的. 量身定制的方法对于克服提供者和机构的障碍,以持续符合指南的护理至关重要.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 实施科学 实施科学
- 外科手术的安全性
背景情况:
- 对于低风险的手术,常规的手术前检测往往是不必要的,并且可能会造成伤害.
- 退出实施策略已经减少了不必要的测试,但提供商采用和战略范围需要进一步了解.
- 利益关方的观点对于成功广泛地实施这些测试至关重要.
研究的目的:
- 评估常规手术前检测的撤销策略的覆盖范围和采用程度.
- 确定影响这些战略实施的障碍和促进因素.
- 了解利益相关者对撤销努力的看法.
主要方法:
- 质量研究涉及采访18名麻醉师,外科医生和医生助理.
- 在RE-AIM框架的指导下进行主题分析.
- 使用实施研究综合框架评估实施障碍.
主要成果:
- 退出实施策略的覆盖率很高,教育会议是最有效的.
- 工作流变化影响了采用;定期会议和数据共享促进了维护.
- 在个人,内部设置和外部设置领域中确定了障碍.
结论:
- 需要量身定制的退出实施策略,以解决提供商和机构障碍.
- 维持符合指南的护理需要克服确定的实施挑战.
- 了解利益相关者的观点是优化退出实施努力的关键.
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