Lee H C, Arora V, Brown T, Lyndon A
Division of Neonatal & Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
California Perinatal Quality Care Collaborative, Stanford, CA, USA.
J Perinatol. 2017 Mar;37(3):249-253. doi: 10.1038/jp.2016.217. Epub 2016 Dec 1.
To evaluate experiences regarding implementation of Neonatal Resuscitation Program (NRP) guideline changes in the context of a collaborative quality improvement (QI) project.
Focus groups were conducted with local QI leaders and providers from nine sites that participated in a QI collaborative. Thematic analysis identified facilitators and barriers to implementation of NRP guideline changes and QI in general.
Facilitators for QI included comparative process measurement and data tracking. Barriers to QI were shifting priorities and aspects of the project that seemed inefficient. Specific to NRP, implementation strategies that worked involved rapid feedback, and education on rationale for change. Changes that interrupted traditional workflow proved challenging to implement. Limited resources and perceptions of increased workload were also barriers to implementation.
Collaborative QI methods are generally well accepted, particularly data tracking, sharing experience and education. Strategies to increase efficiency and manage workload may facilitate improved staff attitudes toward change.
在合作质量改进（QI）项目的背景下，评估新生儿复苏项目（NRP）指南变更的实施经验。
对来自参与QI合作的9个地点的当地QI负责人和提供者进行了焦点小组访谈。主题分析确定了NRP指南变更实施以及一般QI实施的促进因素和障碍。
QI的促进因素包括比较过程测量和数据跟踪。QI的障碍是优先级的变化和项目中看似低效的方面。对于NRP而言，有效的实施策略包括快速反馈以及关于变更理由的教育。中断传统工作流程的变更实施起来颇具挑战。资源有限以及对工作量增加的认知也是实施的障碍。
合作QI方法总体上被广泛接受，尤其是数据跟踪、经验分享和教育。提高效率和管理工作量的策略可能有助于改善工作人员对变革的态度。
