Bender Bruce G, Krishnan Jerry A, Chambers David A, Cloutier Michelle M, Riekert Kristin A, Rand Cynthia S, Schatz Michael, Thomson Carey C, Wilson Sandra R, Apter Andrea, Carson Shannon S, George Maureen, Gerald Joe K, Gerald Lynn, Goss Christopher H, Okelo Sande O, Mularski Richard A, Nguyen Huong Q, Patel Minal R, Szefler Stanley J, Weiss Curtis H, Wilson Kevin C, Freemer Michelle
1 National Jewish Health, Denver, Colorado.
2 University of Illinois Hospital and Health Sciences System, Chicago, Illinois.
Ann Am Thorac Soc. 2015 Dec;12(12):S213-21. doi: 10.1513/AnnalsATS.201506-367OT.
To advance implementation research (IR) in respiratory, sleep, and critical care medicine, the American Thoracic Society and the Division of Lung Diseases from the NHLBI cosponsored an Implementation Research Workshop on May 17, 2014. The goals of IR are to understand the barriers and facilitators of integrating new evidence into healthcare practices and to develop and test strategies that systematically target these factors to accelerate the adoption of evidence-based care. Throughout the workshop, presenters provided examples of IR that focused on the rate of adoption of evidence-based practices, the feasibility and acceptability of interventions to patients and other stakeholders who make healthcare decisions, the fidelity with which practitioners use specific interventions, the effects of specific barriers on the sustainability of an intervention, and the implications of their research to inform policies to improve patients' access to high-quality care. During the discussions that ensued, investigators' experience led to recommendations underscoring the importance of identifying and involving key stakeholders throughout the research process, ensuring that those who serve as reviewers understand the tenets of IR, managing staff motivation and turnover, and tackling the challenges of scaling up interventions across multiple settings.
为推动呼吸、睡眠及重症医学领域的实施研究(IR),美国胸科学会与美国国立心肺血液研究所肺病科于2014年5月17日联合主办了一次实施研究研讨会。实施研究的目标是了解将新证据整合到医疗实践中的障碍和促进因素,并制定和测试系统性针对这些因素的策略,以加速循证护理的采用。在整个研讨会上,发言者提供了实施研究的实例,这些实例聚焦于循证实践的采用率、干预措施对患者及其他医疗决策利益相关者的可行性和可接受性、从业者使用特定干预措施的保真度、特定障碍对干预措施可持续性的影响,以及他们的研究对制定政策以改善患者获得高质量护理的意义。在随后的讨论中,研究人员的经验促成了一些建议,强调在整个研究过程中识别并让关键利益相关者参与的重要性,确保担任评审员的人员理解实施研究的原则,管理员工的积极性和人员流动,并应对在多个环境中扩大干预措施规模所面临的挑战。