改变实施研究和实践的时间
Mike English1,2, Jacob McKnight3, Sassy Molyneux4,3
1KEMRI-Wellcome Research Programme, Nairobi, Kenya. mike.english@ndm.ox.ac.uk.
BMC medicine
|February 3, 2026
概括
实施研究往往忽视了时间. 分析时间作为一个多维资源,揭示了时间短缺和隐藏的时间需求如何影响医疗保健的改善,特别是在资源不足的环境中.
科学领域:
- 实施科学 实施科学
- 卫生系统研究 卫生系统研究
- 组织行为组织行为.
背景情况:
- 实施研究经常忽视时间的关键作用.
- 全球卫生领域利用创新以获得优质护理 (HIGH-Q) 计划强调了时间是采用和维持新实践的关键因素.
- 现有的实施框架没有充分地将时间作为中央分析镜头来解决问题.
研究的目的:
- 通过时间的分析镜头探索实施科学.
- 研究时间短缺和时间结构如何影响复杂卫生系统中新做法的采用和可持续性.
- 提出一个与资源有限的环境中的实施相关的多维时间结构.
主要方法:
- 在HIGH-Q计划中协调民族学,定量和干预研究.
- 分析现有新生儿技术和质量改善支持的医院的劳动力增强.
- 探索时间作为一个有限的,可交易的资源,包括用于反思和适应的"隐藏时间".
主要成果:
- 时间短缺显著限制了在低资源环境中改进和使用新技术.
- 新的临床技术需要大量的用户时间,包括直接和间接的认知和协调工作.
- 任务的优先级,技能发展,反思,团队适应和"隐藏时间"是实施的重要但经常被忽视的组成部分.
- 时间结构和规范可能会阻碍灵活性,而"储备时间"对于弹性至关重要.
结论:
- 通过时间的镜头来看待实施,可以发现隐藏的约束和错位.
- 对时间的多个维度的明确检查对于理解复杂系统中的干预成功或失败至关重要,特别是在资源稀缺的环境中.
- 时间应该被整合到变革理论和实施框架中,以改善实践和结果.
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