实施映射以确定增加及时启动头部/部癌症术后放射治疗的策略
Laila A Gharzai1,2, Jaymie Bromfield3, Michelle Kwan4
1Department of Radiation Oncology, Northwestern University, Chicago, Illinois, USA.
概括
对头癌患者进行及时的术后放射治疗 (PORT) 对生存至关重要. 这项研究确定了障碍,并制定了策略,如临床医生提醒,以提高在学术中心的PORT启动率.
科学领域:
- 在瘤学瘤学.
- 实施科学 实施科学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 及时启动手术后放射治疗 (PORT) 治疗头部和部状细胞癌 (HNSCC) 与改善患者的存活率有关.
- 然而,在许多临床环境中,目前及时启动PORT的速度仍然不够理想.
研究的目的:
- 确定影响HNSCC及时启动PORT的实施决定因素 (障碍和促进因素).
- 设计特定于环境的实施策略,以提高PORT在高等学术中心的普及率.
主要方法:
- 采用了一项连续的混合方法研究,利用基于理论领域框架 (TDF) 的调查来确定决定因素.
- 焦点小组优先考虑了这些决定因素,并使用实施研究综合框架 (CFIR) - 实施变革专家建议 (ERIC) 匹配工具来绘制战略障碍.
- 行动,参与者,上下文,目标,时间 (AACTT) 框架使选择的战略变得可操作.
主要成果:
- 来自放射瘤学,耳鼻喉学和医疗瘤学部门的23名参与者完成了调查.
- 确定了影响 PORT 及时启动的十个决定因素.
- 三种基于证据的策略 - - 提醒临床医生,举办教育会议和促进临床数据中继 - - 已被选中用于实施.
结论:
- 开发了一个可操作的实施策略列表,以支持HNSCC及时启动PORT.
- 代码设计方法,以前线医疗保健工作者的投入为中心,提高了成功部署战略的潜力.
- 系统方法可以作为其他医疗保健环境中流程改进的模型.
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