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利用健康技术评估工具包促进采购:加拿大医院中智能输液泵的案例。

USING THE HEALTH TECHNOLOGY ASSESSMENT TOOLBOX TO FACILITATE PROCUREMENT: THE CASE OF SMART PUMPS IN A CANADIAN HOSPITAL.

机构信息

Centre de Recherche du CHUS and UETMIS,CIUSSS de l'Estrie - CHUS Département d'Économique,École de Gestion,Université de

出版信息

Int J Technol Assess Health Care. 2017 Jan;33(1):54-62. doi: 10.1017/S0266462317000125. Epub 2017 Jun 5.

Abstract

OBJECTIVES

The aim of this study was to present the experience of a Canadian hospital-based health technology assessment (HTA) unit that performed the traditional functions of the HTA process along with many other activities to facilitate the choice of smart pumps.

METHODS

A rapid literature review was initiated, but little evidence was found. Moreover, the evidence provided was too far from our hospital context. To help our decision makers, we offered them a list of various services based on the skills of our HTA unit staff.

RESULTS

To involve our HTA unit in the choice of the new smart pumps led to a strong collaboration between hospital services. After a rapid review on smart pumps, we proceeded to establish the clinical needs, followed by an evaluation of technical features. To ascertain clinical needs, we participated in the establishment of a conformity list for the tender, a failure and mode-effect analysis, an audit on the use of actual smart pumps, and simulation exercises with nurses and doctors to evaluate the ease of use and ergonomics. With regard to technical tests, these were mainly conducted to identify potential dysfunction and to assess the efficiency of the pump. This experience with smart pumps was useful for evidence-based procurement and led to the formulation of a nine-step process to guide future work.

CONCLUSIONS

HTA units and agencies are faced with rapid development of new technologies that may not be supported by sufficient amount of pertinent published evidence. Under these circumstances, approaches other than evidence-based selection might provide useful information. Because these activities may be different from those related to classic HTA, this widens the scope of what can be done in HTA to support decision making.

摘要

目的

本研究旨在介绍一家加拿大医院为基础的健康技术评估(HTA)机构的经验,该机构除了执行传统的 HTA 流程外,还开展了许多其他活动,以促进智能输液泵的选择。

方法

我们迅速开展了文献回顾,但几乎没有发现证据。此外,提供的证据与我们医院的情况相差甚远。为了帮助决策者,我们根据 HTA 部门员工的技能,为他们提供了一系列不同的服务。

结果

让我们的 HTA 部门参与新智能输液泵的选择,促进了医院各部门之间的紧密合作。在对智能输液泵进行快速审查后,我们着手确定临床需求,然后评估技术特性。为了确定临床需求,我们参与了招标的一致性清单制定、失效和模式效果分析、实际智能输液泵使用情况的审核,以及与护士和医生进行模拟练习,以评估易用性和人体工程学。至于技术测试,主要是为了识别潜在的功能障碍,并评估泵的效率。这一智能输液泵的经验对于循证采购很有用,并制定了一个九步流程来指导未来的工作。

结论

HTA 部门和机构面临着新技术的快速发展,但这些技术可能没有足够数量的相关已发表证据支持。在这种情况下,除了基于证据的选择之外,其他方法可能会提供有用的信息。由于这些活动可能与经典 HTA 相关的活动不同,因此扩大了 HTA 可以支持决策的范围。

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