一种审计和评分知识转化（KT）干预措施实施情况的方法——安大略省直肠癌手术的观察性试点研究。

A method to audit and score implementation of knowledge translation (KT) interventions in large health regions - an observational pilot study using rectal cancer surgery in Ontario.

机构信息

Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.

Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.

出版信息

BMC Health Serv Res. 2020 Jun 5;20(1):506. doi: 10.1186/s12913-020-05353-9.

DOI:10.1186/s12913-020-05353-9

PMID:32503592

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7275399/

Abstract

BACKGROUND

Across Ontario, since the year 2006 various knowledge translation (KT) interventions designed to improve the quality of rectal cancer surgery have been implemented by the provincial cancer agency or by individual researchers. Ontario is divided administratively into 14 health regions. We piloted a method to audit and score for each region of the province the KT interventions implemented to improve the quality of rectal cancer surgery.

METHODS

We interviewed stakeholders to audit KT interventions used in respective regions over years 2006 to 2014. Results were summarized into narrative and visual forms. Using a modified Delphi approach, KT experts reviewed these data and then, for each region, scored implementation of KT interventions using a 20-item KT Signature Assessment Tool. Scores could range from 20 to 100 with higher scores commensurate with greater KT intervention implementation.

RESULTS

There were thirty interviews. KT experts produced scores for each region that were bimodally distributed, with an average score for 2 regions of 78 (range 73-83) and for 12 regions of 30.5 (range 22-38).

CONCLUSION

Our methods efficiently identified two groups with similar KT Signature scores. Two regions had relatively high scores reflecting numerous KT interventions and the use of sustained iterative approaches in addition to those encouraged by the provincial cancer agency, while 12 regions had relatively low scores reflecting minimal activities outside of those encouraged by the provincial cancer agency. These groupings will be used for future comparative quantitative analyses to help determine if higher KT signature scores correlate with improved measures for quality of rectal cancer surgery.

摘要

背景

自 2006 年以来，在安大略省的各个地区，省级癌症机构或个别研究人员实施了各种旨在提高直肠癌手术质量的知识转化（KT）干预措施。安大略省在行政上分为 14 个卫生区域。我们试点了一种方法，对全省每个地区实施的改善直肠癌手术质量的 KT 干预措施进行审计和评分。

方法

我们采访了利益相关者，以审计 2006 年至 2014 年期间各自地区使用的 KT 干预措施。结果以叙述和可视化形式进行总结。使用改良 Delphi 方法，KT 专家审查了这些数据，然后，根据 KT 干预措施的实施情况，使用 20 项 KT 签名评估工具对每个地区进行评分。分数范围为 20 到 100，分数越高表示 KT 干预措施的实施程度越高。

结果

共进行了 30 次访谈。KT 专家为每个地区生成了评分，评分呈双峰分布，2 个地区的平均得分为 78（范围为 73-83），12 个地区的平均得分为 30.5（范围为 22-38）。

结论

我们的方法有效地确定了两组具有相似 KT 签名评分的地区。两个地区的评分相对较高，反映了除省级癌症机构鼓励的活动外，还有许多 KT 干预措施和持续迭代方法的使用，而 12 个地区的评分相对较低，反映了除省级癌症机构鼓励的活动外，几乎没有其他活动。这些分组将用于未来的比较定量分析，以帮助确定更高的 KT 签名评分是否与改善直肠癌手术质量的措施相关。