Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
J Eval Clin Pract. 2010 Dec;16(6):1326-32. doi: 10.1111/j.1365-2753.2009.01336.x. Epub 2010 Aug 24.
RATIONALE, AIMS AND OBJECTIVES: The transmission of research findings into routine care is a slow and unpredictable process. Important factors predicting receptivity for innovations within organizations have been identified, but there is a need for further research in this area. The aim of this study was to describe contextual factors and evaluate if organizational climate and implementation strategy influenced outcome, when a computer-based concept for lifestyle intervention was introduced in primary health care (PHC).
The study was conducted using a prospective intervention design. The computer-based concept was implemented at six PHC units. Contextual factors in terms of size, leadership, organizational climate and political environment at the units included in the study were assessed before implementation. Organizational climate was measured using the Creative Climate Questionnaire (CCQ). Two different implementation strategies were used: one explicit strategy, based on Rogers' theories about the innovation-decision process, and one implicit strategy. After 6 months, implementation outcome in terms of the proportion of patients who had been referred to the test, was measured.
The CCQ questionnaire response rates among staff ranged from 67% to 91% at the six units. Organizational climate differed substantially between the units. Managers scored higher on CCQ than staff at the same unit. A combination of high CCQ scores and explicit implementation strategy was associated with a positive implementation outcome.
Organizational climate varies substantially between different PHC units. High CCQ scores in combination with an explicit implementation strategy predict a positive implementation outcome when a new working tool is introduced in PHC.
背景、目的和目标：将研究结果转化为常规护理的过程是缓慢且不可预测的。已经确定了预测组织内创新接受度的重要因素，但需要在该领域进行进一步研究。本研究的目的是描述背景因素，并评估当在初级保健（PHC）中引入基于计算机的生活方式干预概念时，组织氛围和实施策略是否会影响结果。
本研究采用前瞻性干预设计进行。该基于计算机的概念在六个 PHC 单位实施。在实施之前，评估了纳入研究的单位在规模、领导力、组织氛围和政治环境方面的背景因素。组织氛围使用创意氛围问卷（CCQ）进行测量。使用了两种不同的实施策略：一种是基于罗杰斯关于创新决策过程理论的明确策略，另一种是隐含策略。6 个月后，以被转诊接受测试的患者比例来衡量实施结果。
在六个单位中，员工对 CCQ 问卷的回复率在 67%至 91%之间。组织氛围在各单位之间存在显著差异。与同一单位的员工相比，经理在 CCQ 上的得分更高。高 CCQ 分数与明确的实施策略相结合与积极的实施结果相关。
不同的 PHC 单位之间组织氛围存在显著差异。当在 PHC 中引入新的工作工具时，高 CCQ 分数与明确的实施策略相结合可预测积极的实施结果。
