Department of Health sciences in Gjøvik, Norwegian University of Science and Technology in Gjøvik (NTNU), Teknologiveien 22, 2815, Gjøvik, Norway.
SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Kjell Arholmsgate 41, 4036, Stavanger, Norway.
BMC Health Serv Res. 2020 May 11;20(1):397. doi: 10.1186/s12913-020-05272-9.
The increasing complexity and variability in radiology have significantly fueled the need for guidelines. There are many methods for disseminating and implementing guidelines however; and obtaining lasting changes has been difficult. Implementation outcome is usually measured in a decrease in unwarranted examinations, and qualitative data are rarely used. This study's aim was to evaluate a guideline implementation process and identify factors influencing implementation outcome using qualitative data.
Seven general practitioners and five radiological personnel from a Norwegian county participated in four focus group interviews in 2019. The data were analyzed using qualitative content analysis, where some categories were predetermined, while most were drawn from the data.
Four main categories were developed from the data material. 1) Successful/unsuccessful parts of the implementation, 2) perceived changes/lack of changes after the implementation, 3) environment-related factors that affected guideline use, and 4) User related factors that affect guideline use.
Our findings show that clinical guideline implementation is difficult, despite the implementation strategy being tailored to the target groups. Several environment- and user-related factors contributed to the lack of changes experienced in practice for both general practitioners and radiological personnel.
放射学的复杂性和可变性不断增加，极大地推动了制定指南的需求。有许多方法可以传播和实施指南；然而，获得持久的改变一直很困难。实施结果通常以不必要的检查减少来衡量，很少使用定性数据。本研究旨在使用定性数据评估指南实施过程并确定影响实施结果的因素。
2019 年，来自挪威一个县的 7 名全科医生和 5 名放射科人员参加了 4 次焦点小组访谈。使用定性内容分析对数据进行分析，其中一些类别是预先确定的，而大多数则来自数据。
从数据资料中得出了四个主要类别。1）实施的成功/不成功部分，2）实施后感知到的变化/缺乏变化，3）影响指南使用的环境相关因素，以及 4）影响指南使用的用户相关因素。
我们的研究结果表明，尽管实施策略针对目标群体进行了定制，但临床指南的实施仍然很困难。一些环境和用户相关因素导致全科医生和放射科人员在实践中经历了缺乏变化。
