通过实践促进,将实施策略定制为初级保健诊所背景:从ANTECEDENT研究中吸取的教训
Chrystal Barnes1, Erin S Kenzie2,3, Tracey Thomas2
1Oregon Rural Practice-Based Research Network, Oregon Health & Sciences University, Portland, OR, USA. barnesch@ohsu.edu.
实践辅导员通过调整策略以适应上下文因素,为诊所量身定制实施支持. 这种量身定制的方法提高了临床的参与度,并改善了医疗保健机构的质量改善工作.
科学领域:
- 实施科学 实施科学
- 医疗保健管理的管理
- 定性研究方法 定性研究方法
背景情况:
- 基于证据的干预措施的上下文定制是在实施科学中建立的.
- 了解实施支持的促进者驱动定制仍然是一个关键的研究问题.
- 本研究探讨了促进者如何识别和利用上下文因素来定制实施策略.
研究的目的:
- 检查外部实践促进者如何为初级保健诊所量身定制实施支持.
- 确定影响促进者选择和应用实施策略的上下文因素.
- 在实用研究中了解促进者驱动定制的方法和机制.
主要方法:
- 在15个月的实施期间,采用了一种描述性的定性研究设计.
- 数据是通过每两年一次的采访和每月一次的反思与研究资助的辅导员收集的.
- 在ERIC分类和i-PARIHS的指导下,使用框架分析来对定制技术进行分类.
主要成果:
- 促进者在四个领域提供了定制的支持:促进结构/流程,技术援助,需求评估和技能培养.
- 根据临床特定的上下文因素,使用各种技术调整了共同的实施策略.
- 定制既有主动性又有反应性,减少了行政负担,改善了诊所的参与和招生.
结论:
- 促进者有效地根据四个关键领域的临床因素量身定制实施支持.
- 调节者定制对于加强诊所参与质量改进计划至关重要.
- 未来的研究应该评估特定定制技术对绩效结果的影响.
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