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创新外科技术的机构采用模式。

A model for the institutional adoption of innovative surgical techniques.

机构信息

Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA.

Department of Surgery, University of California, San Francisco, CA.

出版信息

Surgery. 2020 Aug;168(2):238-243. doi: 10.1016/j.surg.2020.03.018. Epub 2020 May 4.

Abstract

BACKGROUND

Surgeons have the responsibility to continuously enhance surgical practice. Standardized processes for institutions to validate and approve the introduction of innovative surgical techniques do not exist. The objective of this work was to develop a model for the introduction of innovative surgical techniques, which assists the innovating surgeons and institution with safe implementation.

METHOD

A staged model for the institutional introduction of innovative surgical techniques was developed. Relevant concepts were introduced and defined, a framework for preparation and implementation was established, and an oversight structure was delineated.

RESULTS

Systematic literature review and expert opinion revealed broad agreement on the core principles and theory of surgical innovation, but also noted a lack of specific processes. Our efforts aimed to both codify principles and provide a model for specific, best-practice workflows. Important concepts and outputs included: (1) appropriate definition of a sufficiently "new technique" requiring oversight; (2) the appropriate groundwork to be performed to plan for the implementation of the new technique; (3) patient-facing responsibilities, including informed consent; and (4) division of the introduction/adoption process into defined phases, starting from initial discovery and preparation to piloting and transition to standard practice, each with distinct, phase-specific tasks.

CONCLUSION

We present a generalizable framework for approaching the safe introduction and adoption of innovative surgical techniques.

摘要

背景

外科医生有责任不断提高手术水平。目前,各医疗机构在验证和批准创新性手术技术的应用方面,尚无标准化流程。本研究旨在开发一种创新性手术技术的引入模式,为创新外科医生和医疗机构的安全实施提供帮助。

方法

建立了医疗机构引入创新性手术技术的分阶段模型。引入并定义了相关概念,建立了准备和实施的框架,并划定了监督结构。

结果

系统文献回顾和专家意见广泛认同外科创新的核心原则和理论,但也指出缺乏具体流程。我们的努力旨在编纂原则并提供具体的最佳实践工作流程模型。重要的概念和成果包括:(1)适当定义需要监督的足够“新技术”;(2)为新技术的实施进行适当的准备工作;(3)面向患者的责任,包括知情同意;(4)将引入/采用过程分为定义明确的阶段,从最初的发现和准备到试点和过渡到标准实践,每个阶段都有独特的、特定阶段的任务。

结论

我们提出了一种可推广的方法,用于安全引入和采用创新性手术技术。

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