Luck Jeff, York Laura S, Bowman Candice, Gale Randall C, Smith Nina, Asch Steven M
Oregon State University, Corvallis, OR; Veterans Administration (VA) Greater Los Angeles Healthcare System, Los Angeles; VA Palo Alto Health Care System; and Stanford University, Palo Alto, CA
Oregon State University, Corvallis, OR; Veterans Administration (VA) Greater Los Angeles Healthcare System, Los Angeles; VA Palo Alto Health Care System; and Stanford University, Palo Alto, CA.
J Oncol Pract. 2015 May;11(3):e421-7. doi: 10.1200/JOP.2014.003012. Epub 2015 Apr 7.
Peer-to-peer collaboration within integrated health systems requires a mechanism for sharing quality improvement lessons. The Veterans Health Administration (VA) developed online compendia of tools linked to specific cancer quality indicators. We evaluated awareness and use of the toolkits, variation across facilities, impact of social marketing, and factors influencing toolkit use.
A diffusion of innovations conceptual framework guided the collection of user activity data from the Toolkit Series SharePoint site and an online survey of potential Lung Cancer Care Toolkit users.
The VA Toolkit Series site had 5,088 unique visitors in its first 22 months; 5% of users accounted for 40% of page views. Social marketing communications were correlated with site usage. Of survey respondents (n = 355), 54% had visited the site, of whom 24% downloaded at least one tool. Respondents' awareness of the lung cancer quality performance of their facility, and facility participation in quality improvement collaboratives, were positively associated with Toolkit Series site use. Facility-level lung cancer tool implementation varied widely across tool types.
The VA Toolkit Series achieved widespread use and a high degree of user engagement, although use varied widely across facilities. The most active users were aware of and active in cancer care quality improvement. Toolkit use seemed to be reinforced by other quality improvement activities. A combination of user-driven tool creation and centralized toolkit development seemed to be effective for leveraging health information technology to spread disease-specific quality improvement tools within an integrated health care system.
综合医疗系统内的对等协作需要一种分享质量改进经验教训的机制。退伍军人健康管理局（VA）开发了与特定癌症质量指标相关的工具在线汇编。我们评估了工具包的知晓度和使用情况、各机构间的差异、社会营销的影响以及影响工具包使用的因素。
创新扩散概念框架指导了从工具包系列SharePoint网站收集用户活动数据，并对潜在肺癌护理工具包用户进行在线调查。
VA工具包系列网站在最初的22个月中有5088名独立访客；5%的用户占页面浏览量的40%。社会营销通信与网站使用相关。在调查受访者（n = 355）中，54%访问过该网站，其中24%至少下载了一个工具。受访者对其所在机构肺癌质量表现的知晓度以及机构参与质量改进协作与工具包系列网站的使用呈正相关。机构层面肺癌工具的实施在不同工具类型之间差异很大。
VA工具包系列得到了广泛使用和高度的用户参与，尽管各机构间的使用情况差异很大。最活跃的用户了解并积极参与癌症护理质量改进。工具包的使用似乎因其他质量改进活动而得到加强。用户驱动的工具创建和集中式工具包开发相结合似乎有效地利用了健康信息技术在综合医疗系统内传播特定疾病的质量改进工具。
