内部促进流程与参与质量改善合作以减少剖腹产产生的医院之间的实施结果之间的关系:混合方法嵌入案例研究
Jennifer A Callaghan-Koru1, Rachel Blankstein Breman2, Bonnie DiPietro3
1Department of Health Behavior and Health Education, Department of Obstetrics & Gynecology, and Center for Implementation Research, University of Arkansas for Medical Sciences, Fayetteville, AR, USA. jck@uams.edu.
Implementation science communications
|May 7, 2025
概括
内部便利化流程对质量改进协作机构 (QIC) 在实施基于证据的实践方面取得的成功有重大影响. 加强这些内部促进 (IF) 流程可以提高QIC的有效性,以获得更好的医疗保健结果.
科学领域:
- 医疗保健管理的管理
- 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:
- 质量改进协作 (QIC) 被广泛用于基于证据的实践实施.
- 在QIC参与者之间,可变的表现需要了解内部因素.
- 内部便利化 (IF) 流程至关重要,但在QIC中研究不足.
研究的目的:
- 检查参与围产期质量改善协作 (QIC) 的医院内部的内部促进 (IF) 流程.
- 评估IF流程与实施减少初次剖腹产产生的国家指南之间的关系.
- 确定影响IF流程的上下文决定因素.
主要方法:
- 混合方法嵌入案例研究设计,涉及21家医院.
- 在iPARIHS和CFIR框架的指导下,与内部实施领导人的定性访谈.
- 七个IF流程的独立编码和评级使用修改的CFIR框架,最终评级达成共识.
主要成果:
- 医院领导人从事各种IF活动,评级范围从-1.1到+1.5.5.
- 项目管理的平均评分最高 (1.0),规划的平均评分最低 (0.5).
- 较高的IF评级与更大的实践变革实施相关;工作基础设施和关系联系是关键影响因素.
结论:
- 内部促进 (IF) 流程是围产期质量改进协作 (QIC) 实施成功的关键决定因素.
- 在参与组织中监测和增强IF流程可以提高QIC的有效性.
- 针对IF流程提供了一种战略,以优化实施协作的影响.
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