实施ICD-11的促进者和挑战:使用实施科学综合框架的定性研究
Erwyn Chin Wei Ooi1,2, Zaleha Md Isa3, Mohd Rizal Abdul Manaf4
1Department of Public Health Medicine, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia. ooi.erwyn@gmail.com.
这项研究探讨了在马来西亚实施国际疾病分类第十一版 (ICD-11) 的促进者和挑战. 这些研究结果为在不同系统中成功采用全国性的方法提供了洞察力.
科学领域:
- 医疗信息学
- 公共卫生
- 医疗服务研究
背景情况:
- 国际疾病分类 (ICD-11) 的第十一版于2019年通过,全球各国正在试点实施.
- 了解ICD-11实施的挑战和促进者,特别是在多种系统中,对于成功采用至关重要.
- 之前的研究还没有充分探讨在异质系统环境中的实施者的观点.
研究的目的:
- 确定在马来西亚实施ICD-11期间遇到的关键推动者和挑战.
- 从国家一级实施者的角度了解影响ICD-11采用的因素.
- 为改善未来的ICD-11实施策略提供见解.
主要方法:
- 通过对马来西亚15个国家级 ICD-11 实施者进行半结构化采访来收集定性数据.
- 综合实施研究框架 (CFIR) 2022被用于分析定性数据.
- 用传统的定性内容分析来确定促进者和挑战.
主要成果:
- 促进者包括强有力的领导力,现有用例,全面的术语服务,可试用性,成本效益,外部合作,法律改进,明确的角色,有效的沟通,新出现的需求,工作流的适用性,知识获取,团队动机,现有框架和积极参与的团队.
- 发现的挑战包括ICD-11的复杂性,定制需求,高层管理层缺乏支持,供应商学习曲线,文档不足,基础设施过时,数据重复/有效性问题,劳动力限制,对工作流程的影响,资金限制和技术专业知识差距.
结论:
- 全国采用ICD-11涉及关键的编码,技术和政策方面.
- 应对已识别的促进者和挑战对于在多样化的医疗保健系统中成功实施至关重要.
- 未来的研究应该集中在用户的观点和在不同环境中实施战略的适应性上.
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