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指南制定者并非唯一的专家:利用 FRAM 方法制定脓毒症路径。

Guideline developers are not the only experts: Utilising the FRAM method in sepsis pathways.

机构信息

SAPPHIRE, Health Sciences, University of Leicester, Leicester, LE1 7RH, UK.

Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, Children's Emergency Department, Leicester Royal Infirmary, Infirmary Square, Leicester, LE1 5WW, UK.

出版信息

BMC Med. 2018 Nov 21;16(1):213. doi: 10.1186/s12916-018-1212-6.

DOI:10.1186/s12916-018-1212-6
PMID:30458769
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6247527/
Abstract

Improving clinical outcomes and quality of care in diseases such as sepsis, which are heterogeneous in their presenting signs and symptoms, is a challenge. One approach is to utilise the Functional Analysis Resonance Method (FRAM), which enables systems to examine process and sociocontextual issues in treatment and management pathways. McNab et al. applied FRAM to group of primary care (family) practices to understand the barriers and enablers in the management of sepsis and determined a suite of possible interventions that might improve patient care. This commentary reviews the FRAM process and highlights some core issues for systems to consider when tackling diseases like sepsis.Please see related article: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-018-1164-x.

摘要

改善脓毒症等疾病的临床结果和护理质量是一项挑战,这些疾病的临床表现和症状存在异质性。一种方法是利用功能分析共鸣方法(FRAM),该方法使系统能够检查治疗和管理途径中的过程和社会文化问题。McNab 等人将 FRAM 应用于一组初级保健(家庭)实践中,以了解脓毒症管理中的障碍和促成因素,并确定了一系列可能改善患者护理的干预措施。本评论回顾了 FRAM 过程,并强调了系统在处理脓毒症等疾病时需要考虑的一些核心问题。请参阅相关文章:https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-018-1164-x。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a95/6247527/0c9c07a2f32e/12916_2018_1212_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a95/6247527/0c9c07a2f32e/12916_2018_1212_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a95/6247527/0c9c07a2f32e/12916_2018_1212_Fig1_HTML.jpg

相似文献

1
Guideline developers are not the only experts: Utilising the FRAM method in sepsis pathways.指南制定者并非唯一的专家:利用 FRAM 方法制定脓毒症路径。
BMC Med. 2018 Nov 21;16(1):213. doi: 10.1186/s12916-018-1212-6.
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Where the rubber meets the road: using FRAM to align work-as-imagined with work-as-done when implementing clinical guidelines.理论与实践的结合:在实施临床指南时运用FRAM将设想中的工作与实际完成的工作相匹配。
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引用本文的文献

1
Development and application of 'systems thinking' principles for quality improvement.用于质量改进的“系统思维”原则的发展与应用。
BMJ Open Qual. 2020 Mar;9(1). doi: 10.1136/bmjoq-2019-000714.

本文引用的文献

1
Participatory design of an improvement intervention for the primary care management of possible sepsis using the Functional Resonance Analysis Method.使用功能共振分析方法参与设计改善疑似脓毒症的初级保健管理的干预措施。
BMC Med. 2018 Oct 11;16(1):174. doi: 10.1186/s12916-018-1164-x.
2
'So why didn't you think this baby was ill?' Decision-making in acute paediatrics.那么你为什么不认为这个婴儿生病了呢?急性儿科学中的决策制定。
Arch Dis Child Educ Pract Ed. 2019 Feb;104(1):43-48. doi: 10.1136/archdischild-2017-313199. Epub 2018 Mar 1.
3
Raising concerns about the Sepsis-3 definitions.
对 Sepsis-3 定义提出担忧。
World J Emerg Surg. 2018 Jan 25;13:6. doi: 10.1186/s13017-018-0165-6. eCollection 2018.
4
The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).《脓毒症及脓毒性休克第三次国际共识定义(脓毒症-3)》
JAMA. 2016 Feb 23;315(8):801-10. doi: 10.1001/jama.2016.0287.