Department of Oral and Maxillofacial Surgery, 6993Erasmus University Medical Center, Rotterdam, the Netherlands.
Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA.
Cleft Palate Craniofac J. 2022 Jan;59(1):5-13. doi: 10.1177/1055665621997668. Epub 2021 Mar 5.
To identify barriers and facilitators to international implementation of a prospective system for standardized outcomes measurement in cleft care.
Cleft teams that have implemented the International Consortium for Health Outcomes Measurement Standard Set for cleft care were invited to participate in this 2-part qualitative study: (1) an exploratory survey among clinicians, health information technology professionals, and project coordinators, and (2) semistructured interviews of project leads. Thematic content analysis was performed, with organization of themes according to the dimensions of the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework: reach, effectiveness, adoption, implementation, and maintenance.
Four cleft teams in Europe and North America participated in this study. Thirteen participants completed exploratory questionnaires and 5 interviewees participated in follow-up interviews. Survey responses and thematic content analysis revealed common facilitators and barriers to implementation at all sites. Teams reach patients either via email or during the clinic visit to capture patient-reported outcomes. Adopting routine data collection is enhanced by aligning priorities at the organizational and cleft team level. Streamlining workflows and developing an efficient data collection platform are necessary early on, followed by pilot testing or stepwise implementation. Regular meetings and financial resources are crucial for implementing, sustaining, analyzing collected data, and providing feedback to health care professionals and patients. Fostering patient-centered care was articulated as a positive outcome, whereas time presented challenges across all RE-AIM dimensions.
Identified themes can inform ongoing implementation efforts. Intentionally investing time to lay a sound foundation early on will benefit every phase of implementation and help overcome barriers such as lack of support or motivation.
确定国际实施前瞻性标准化结局测量系统以改善唇腭裂护理的障碍和促进因素。
邀请已实施唇腭裂护理国际健康结局测量联合会标准集的唇腭裂团队参与这项两部分的定性研究：（1）对临床医生、健康信息技术专业人员和项目协调员进行探索性调查；（2）对项目负责人进行半结构化访谈。采用主题内容分析法，根据可及性、有效性、采用、实施和维持（RE-AIM）框架的维度组织主题：可及性、有效性、采用、实施和维持。
欧洲和北美的 4 个唇腭裂团队参与了这项研究。13 名参与者完成了探索性问卷，5 名受访者参加了后续访谈。调查答复和主题内容分析揭示了所有地点实施的共同促进因素和障碍。团队通过电子邮件或在诊所就诊时与患者联系，以获取患者报告的结局。通过在组织和唇腭裂团队层面上调整优先级，促进常规数据收集。简化工作流程并开发高效的数据收集平台是必要的，之后是试点测试或逐步实施。定期会议和财务资源对于实施、维持、分析收集的数据以及向医疗保健专业人员和患者提供反馈至关重要。将以患者为中心的护理作为积极的结果得到体现，而时间在所有 RE-AIM 维度上都构成了挑战。
确定的主题可以为正在进行的实施工作提供信息。有意投入时间尽早打下坚实的基础将有利于实施的每一个阶段，并有助于克服缺乏支持或动力等障碍。
