Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, CA.
Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA.
J Pediatr. 2021 Oct;237:237-243.e2. doi: 10.1016/j.jpeds.2021.05.045. Epub 2021 May 21.
To characterize the views of members of the multi-disciplinary team regarding the implementation of rapid whole-genome sequencing (rWGS) as a first-tier test for critically ill children in diverse children's hospital settings.
Qualitative interviews informed by implementation science theory were conducted with the multidisciplinary patient care teams and hospital leaders at each of the 5 tertiary care children's hospitals involved in a statewide rWGS implementation project.
Our analysis revealed 5 key themes regarding the implementation process across the sites: the need for rWGS champions, educational needs and strategies, negotiating decision-making roles and processes, workflows and workarounds, and perceptions about rWGS. From the findings a composite clinical workflow diagram was developed to summarize all of the processes involved in the implementation of the test, and the key areas where implementation practices differed.
These findings provide insights for design of interventions to support adoption, scale-up, and sustainability of rWGS and other novel technologies in neonatal and pediatric critical care settings.
描述多学科团队成员对在不同儿童医院环境中对危重症儿童实施快速全基因组测序（rWGS）作为一线检测方法的看法。
在参与全州范围内 rWGS 实施项目的 5 家三级儿童护理医院中，采用实施科学理论指导的定性访谈，对多学科患者护理团队和医院领导进行了访谈。
我们的分析揭示了在整个站点实施过程中的 5 个关键主题：rWGS 拥护者的需求、教育需求和策略、协商决策角色和流程、工作流程和变通办法，以及对 rWGS 的看法。从研究结果中，我们开发了一个综合临床工作流程图，以总结该测试实施所涉及的所有流程，以及实施实践存在差异的关键领域。
这些发现为设计干预措施提供了依据，以支持 rWGS 和新生儿及儿科危重症护理环境中的其他新技术的采用、推广和可持续性。
