在现实环境中进行严格的实施评估:从一个共识方法的经验教训到选择性外科手术的周围手术途径实施
Lisa Pagano1, Andrew Hirschhorn2, Gaston Arnolda3
1Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia. lisa.pagano@mq.edu.au.
Implementation science communications
|February 6, 2026
概括
使用共识实现标准化的外科手术周边途径是可行的,但具有混合的忠实性结果. 与工作人员共同设计战略,并将其定制为学科,改善了医疗保健机构的实施和采用.
科学领域:
- 医疗实施科学 医疗实施科学
- 临床途径的发展发展.
- 准实验性的研究设计.
背景情况:
- 对于最大限度地从单个网站实施研究中吸取教训,存在有限的指导.
- 这项研究解决了在实施科学的实际见解的需要.
- 评估标准化的外科手术路径提供了可转移的经验教训.
研究的目的:
- 评估一个共识过程,以开发和实施标准化的外科手术路径.
- 为进行严格的,以理论为基础的实施评估提供实际见解.
- 为了在医疗保健中实现科学,产生可转移的见解.
主要方法:
- 在澳大利亚一家私立医院进行的多方法,准实验性研究.
- 使用探索,准备,实施和维持 (EPIS) 框架实施的六个基于共识的外科护理途径.
- 面试和观察的专题分析,规范化过程理论 (NPT) 的应用,以及医疗记录审计以评估准确性.
主要成果:
- 标准化的外科手术周围途径被认为是可以接受的,适当的和可行的.
- 在四个手术队伍中,只有两组的途径忠实性得到改善.
- 实施受到EPIS框架要素和NPT机制的影响,其中内部环境和创新因素是最有影响力的.
结论:
- 本研究提供了一个实用的案例研究,用于在现实世界医疗保健中以理论为基础的实施评估.
- 提供了有价值的见解,以实现实施科学原则的运作.
- 定制策略和与前线人员共同设计是推动当地变革的关键.
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