Post-doctoral Fellow, St John's Rehab Research Program, Sunnybrook Health Sciences Centre, 574553Sunnybrook Research Institute, Toronto, ON, Canada.
Research Analyst, Post-doctoral Fellow, St John's Rehab Research Program, Sunnybrook Health Sciences Centre, 574553Sunnybrook Research Institute, Toronto, ON, Canada.
J Health Serv Res Policy. 2022 Oct;27(4):313-320. doi: 10.1177/13558196221103662. Epub 2022 May 20.
This study sought to identify the organisation and system level barriers and facilitators influencing the implementation of patient navigator programmes in one acute care hospital system in Toronto, Canada.
A qualitative descriptive approach informed by the Consolidated Framework for Implementation Research. Data were collected using in-depth interviews and analysed thematically.
Thirty-eight individuals participated in interviews (17 community, 21 acute care hospital), including 24 frontline clinicians and 14 programme directors, health care leaders and managers. Implementation of patient navigator programmes was dependent on: (1) a clear consensus on the unique need for patient navigators; (2) champions to promote patient navigation; (3) programme ownership and accountability; (4) external system and organisational landscape and (5) implementation climate. Appropriate mechanisms of communication were found to have impacted each factor as a barrier or facilitator to programme implementation.
Strategies for implementing patient navigator programmes into hospital clinical practice should include incorporating evidence to support the programme, considering mechanisms to enable collaborative communication, and the integration of frameworks to facilitate programme integration into the current practices within the organisation.
本研究旨在确定影响加拿大多伦多一家急性护理医院系统中患者导航员计划实施的组织和系统层面的障碍和促进因素。
采用实施研究综合框架指导的定性描述方法。使用深入访谈收集数据,并进行主题分析。
共有 38 人参与了访谈(17 名社区人员,21 名急性护理医院人员),包括 24 名一线临床医生和 14 名项目主任、医疗保健领导人和管理人员。患者导航员计划的实施取决于:(1)明确一致认为患者导航员具有独特的需求;(2)拥护者来促进患者导航;(3)项目所有权和问责制;(4)外部系统和组织环境;(5)实施氛围。发现适当的沟通机制对每个因素都有影响,既是计划实施的障碍,也是促进因素。
将患者导航员计划纳入医院临床实践的实施策略应包括纳入支持该计划的证据,考虑促进协作沟通的机制,以及整合框架,以促进该计划融入组织内的现有实践。