对实施推动干预措施进行定性分析,以减少术后阿片类药物处方
Meghan C Martinez1, Kathryn Bouskill2, Xiaowei Sherry Yan3
1Palo Alto Medical Foundation Research Institute & Center for Health Systems Research, Sutter Health, 795 El Camino Real, Ames Building, Palo Alto, CA, 94301, USA. Meghan.martinez@sutterhealth.org.
BMC health services research
|April 8, 2025
概括
通过解决外科医生的反和工作流集成,电子邮件推动成功地减少了指导方针以上的阿片类药物处方. 在医疗保健系统中有效实施这些干预措施时,背景因素是关键因素.
科学领域:
- 医疗保健实施科学 医疗保健实施科学
- 改善临床实践的改善
- 阿片类药物处方分析分析
背景情况:
- 减少未使用的阿片类药物可用性对于缓解阿片类药物危机至关重要.
- 电子邮件"推动"是一种减少术后阿片类药物处方超过指南的策略.
- 了解实施因素对于成功的干预措施至关重要.
研究的目的:
- 描述影响电子邮件推动干预实施和结果的上下文因素.
- 为未来传播旨在减少阿片类药物过度处方的干预措施提供信息.
主要方法:
- 电子邮件的提示被发送给了指导方针以上的阿片类药物处方的外科医生 (2021年10月至2022年9月).
- 36名外科医生接受了采访 (2022年9月至2023年1月),以探索实施因素.
- 实施研究综合框架 (CFIR) 指导了对上下文因素的分析.
主要成果:
- 所有五个CFIR领域的因素都影响了干预措施的可接受性,可行性和可持续性.
- 突击设计,比较器有效性和交付方法是创新领域的关键.
- 外部设置 (法规) 和内部设置 (医院结构) 因素,以及当地冠军和工作流集成,是至关重要的.
结论:
- 外科医生对推动的接受度受到了实施背景的影响.
- 未来的干预措施必须考虑规定工作流程,信息交付和系统级调整.
- 这些发现可能适用于除了阿片类药物处方之外的其他临床医生指导的,基于推动的干预措施.
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