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运用理论领域框架评估医疗保健专业人员实施出院后信息系统的情况:采用多阶段设计的定性研究和德尔菲专家讨论方案。

Evaluation of the implementation of information system for postdischarge with the theoretical domains framework by healthcare professionals: a multistage design with qualitative inquiry and Delphi expert discussion protocol.

机构信息

Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China

Hong Kong Hospital Authority, Hong Kong, China.

出版信息

BMJ Open. 2021 Dec 10;11(12):e046081. doi: 10.1136/bmjopen-2020-046081.

Abstract

INTRODUCTION

Improving discharge information dissemination may improve patients' health literacy of self-care and health outcomes, avoid unnecessary healthcare utilisation, and reduce the healthcare cost. This study aims to use an implementation science theory guided approach to examine the beliefs and behaviours of healthcare professionals regarding postdischarge information summary (PDIS) implementation in a public inpatient setting.

METHODS AND ANALYSIS

A multistage study design involving qualitative inquiry and Delphi expert discussion will be used to systematically explore the perceived barriers in the four implemented hospitals and enable the full implementation of the PDIS in geriatric and medical care. The theoretical domains framework (TDF), behavioural change wheel and realistic evaluation framework will be used to guide the investigation of implementation. This study consists of three steps: (1) identifying barriers and enablers from an implementation perspective using a TDF-informed interview guide; (2) devising theory-based implementation strategy packages to facilitate the adoption and enhancement of PDIS by performing a strategy mapping exercise and (3) developing an effective implementation strategy package for scaling up PDIS in other target hospitals as well as other specialities using the Delphi expert discussion. The goal of this multistage study design is to identify the perspectives from healthcare professionals towards the PDIS implementation and explore their barriers and facilitators of the process in the pilot phase. The invited healthcare professionals would share their daily experience on providing PDIS to patient in various study hospitals with similar ward setting. The implementation of discharge intervention in a study setting through different steps to aid in the exploration and development of the modified implementation strategies for the adoption and enhancement of PDIS in the discharge process.

ETHICS AND DISSEMINATION

Ethics approval for the study was obtained from the Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committees. Results of the study would be released as a report submitted to the Health and Medical Research Fund of Food and Health Bureau of the Hong Kong Government. The result would also be published in international peer-reviewed medical journals and presented in conferences.

TRIAL REGISTRATION NUMBER

ChiCTR2000034382.

摘要

简介

改善出院信息传播可以提高患者自我护理和健康结果的健康素养,避免不必要的医疗保健利用,并降低医疗保健成本。本研究旨在使用实施科学理论指导的方法,研究医疗机构专业人员在公共住院环境中实施出院信息摘要(PDIS)的信念和行为。

方法和分析

本研究采用多阶段设计,包括定性研究和德尔菲专家讨论,旨在系统地探索在 4 家实施医院中 PDIS 实施的感知障碍,并使 PDIS 在老年医学和医疗保健中全面实施。理论领域框架(TDF)、行为改变车轮和现实评价框架将用于指导实施的调查。本研究包括三个步骤:(1)使用 TDF 知情访谈指南从实施角度识别障碍和促进因素;(2)通过策略映射练习设计基于理论的实施策略包,以促进 PDIS 的采用和增强;(3)使用德尔菲专家讨论为其他目标医院以及其他专业领域开发有效的 PDIS 推广实施策略包。多阶段设计的目标是确定医疗保健专业人员对 PDIS 实施的观点,并在试点阶段探索他们在该过程中的障碍和促进因素。受邀的医疗保健专业人员将分享他们在不同研究医院的日常经验,这些医院的病房设置相似。通过不同步骤在研究环境中实施出院干预,以帮助探索和制定修改后的实施策略,以促进 PDIS 在出院过程中的采用和增强。

伦理和传播

该研究已获得香港中文大学-新界东联区临床研究伦理委员会的伦理批准。研究结果将作为提交给香港食物及卫生局卫生及医疗研究基金的报告发布。研究结果还将发表在国际同行评议的医学期刊上,并在会议上展示。

试验注册号

ChiCTR2000034382。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19c7/8666896/2d5776ad6520/bmjopen-2020-046081f01.jpg

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