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紧急医疗实践中低价值诊断测试的驱动因素:一种定性描述性研究
Vinay Gangathimmaiah1,2, Rebecca Evans2, Nishila Moodley3,2
1Townsville Hospital and Health Service, Townsville, Queensland, Australia drvinaybg@gmail.com.
由于六个关键驱动因素,包括效率和文化,急诊医生进行低价值的诊断测试. 解决这些系统和个体因素对于撤销实施和改善患者护理至关重要.
科学领域:
- 紧急医疗 紧急医疗
- 医疗保健服务研究 医疗服务研究
- 行为科学 行为科学
背景情况:
- 低值的诊断测试有助于伤害患者和压力医疗保健系统.
- 了解低值测试利用的决定因素对于有效的退出实施策略至关重要.
研究的目的:
- 调查影响在紧急医疗实践中执行低值诊断测试的主要驱动因素.
- 确定影响低值测试的系统和个体因素.
主要方法:
- 一项定性描述性研究,涉及与澳大利亚学术急诊部的24名急诊医生 (19名高级医生,5名实习生) 进行半结构面试.
- 专题分析采访数据,使用理论领域框架编码和分类,以探索行为影响.
主要成果:
- 确定了低值测试的六个核心驱动因素:效率,文化,资源,复杂性,后果和能力.
- 这些驱动因素在系统和个人层面上都起作用,作为障碍物或推动者来阻止实施.
- 驱动因素映射到理论领域框架内的特定行为领域,包括环境背景,社会影响,对后果的信念和能力.
结论:
- 一个复杂的系统和个体驱动器网络影响急诊医生决定订购低价值测试.
- 取消实施需要改变行为,需要采取多层次的方法来解决已识别的驱动因素.
- 基于理论的,共同设计的干预措施对于成功导航这些驱动因素和减少低值测试利用至关重要.
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