Department of Didactics and Educational Research in Health Science, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany.
PedScience Research Institute, 45711 Datteln, Germany.
Int J Environ Res Public Health. 2022 Jan 1;19(1):453. doi: 10.3390/ijerph19010453.
Pediatric palliative care (PPC) patients require years of care across professions and sectors. Sharing treatment-related information and communicating among different PPC professionals is critical to ensure good quality of care. In Germany, this communication is mostly paper-based and prone to errors. Therefore, an electronic cross-facility health record (ECHR) was participatorily designed with users, wherein information can be shared and PPC professionals can communicate with each other. As this form of electronic health record differs from existing models in Germany, there is a need for successful implementation to ensure a positive impact. Therefore, the facilitators and barriers to the implementation of ECHR in PPC were examined. Using the consolidated framework for implementation research (CFIR), transcripts of 32 interviews, 3 focus groups, and 20 think-aloud studies with PPC professionals were analyzed. CFIR indicated that the ECHR-design was viewed positively by users and can be a facilitator for implementation. Barriers exist, mainly due to the fact that the implementation is not planned, the use of the ECHR involves effort, costs are not covered, and all users must be motivated to use the ECHR for functionality. CFIR helps uncover the crux of the issues that need to be considered when planning ECHR implementation to improve care in PPC.
儿科姑息治疗 (PPC) 患者需要多年的跨专业和跨部门的护理。分享与治疗相关的信息并在不同的 PPC 专业人员之间进行沟通对于确保高质量的护理至关重要。在德国，这种沟通主要是基于纸质文件的，容易出错。因此，与用户共同设计了一种跨机构的电子健康记录 (ECHR)，以便共享信息和 PPC 专业人员之间进行沟通。由于这种电子健康记录的形式与德国现有的模式不同，因此需要成功实施，以确保产生积极影响。因此，研究人员考察了在 PPC 中实施 ECHR 的促进因素和障碍。研究人员使用实施研究综合框架 (CFIR)，对 32 名 PPC 专业人员的访谈记录、3 个焦点小组和 20 次出声思维研究进行了分析。CFIR 表明，用户对 ECHR 的设计持积极态度，并且可以成为实施的促进因素。但存在障碍，主要是因为实施没有计划，使用 ECHR 需要付出努力，成本没有得到覆盖，并且所有用户都必须有动力使用 ECHR 来实现其功能。CFIR 有助于揭示在规划 ECHR 实施时需要考虑的问题的关键，以改善 PPC 中的护理。
