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利用旨在提高初级保健中癌症转诊安全性的电子安全网工具:使用快速评估方法进行定性服务评估。

Using an electronic safety netting tool designed to improve safety with respect to cancer referral in primary care: a qualitative service evaluation using rapid appraisal methods.

机构信息

Wolfson Institute of Population Health, Queen Mary University of London, London, UK

Department of Applied Health Research, University College London, London, UK.

出版信息

BMJ Open Qual. 2023 Jul;12(3). doi: 10.1136/bmjoq-2023-002354.

Abstract

BACKGROUND

This evaluation assesses the impact of an electronic safety netting software (E-SN) package, C the Signs, in primary care services across five boroughs in North East London (NEL).

AIM

This study evaluates the use of E-SN software in primary care, examining its benefits and barriers, safety implications, and overall impact on individual and practice usage.

DESIGN AND SETTING

The study is based on semi-structured interviews with 21 clinical and non-clinical members of staff from all primary care services using the software in NEL.

METHOD

Semi-structured interviews were conducted to gather data on individual use of the software, safety implications and practice use of features such as the monitoring dashboard. Data were analysed using a rapid qualitative methodology.

RESULTS

Two approaches to E-SN software adoption were reported: whole practice adoption and self-directed use. Practices benefitted from shared responsibility for safety netting and using software to track patients' progress in secondary care. Adoption was affected by information technology and administrative resources. Decision-support tools were used infrequently due to a lack of appreciation for their benefits. Selective adoption of different E-SN functions restricted its potential impact on early diagnosis.

CONCLUSION

The use of E-SN software in primary care services in NEL varied among participants. While some found it to be beneficial, others were sceptical of its impact on clinical decision-making. Nonetheless, the software was found to be effective in managing referral processes and tracking patients' progress in other points of care.

摘要

背景

本评估旨在考察电子安全网软件(E-SN)包 C the Signs 在伦敦东北部五个行政区的基层医疗服务中的影响。

目的

本研究评估了 E-SN 软件在基层医疗中的使用情况,考察其益处和障碍、安全影响以及对个人和实践使用的总体影响。

设计和设置

本研究基于对使用该软件的 NEL 所有基层医疗服务的 21 名临床和非临床工作人员的半结构式访谈。

方法

采用半结构式访谈收集个人使用软件、安全影响以及监测仪表板等功能的实践使用数据。采用快速定性方法进行数据分析。

结果

报告了两种 E-SN 软件采用方法:整个实践采用和自我导向采用。实践受益于安全网共享责任和使用软件跟踪患者在二级医疗中的进展。采用受到信息技术和行政资源的影响。决策支持工具由于对其益处缺乏认识而很少使用。对不同 E-SN 功能的选择性采用限制了其对早期诊断的潜在影响。

结论

E-SN 软件在 NEL 的基层医疗服务中的使用在参与者中存在差异。虽然有些人认为它有益,但也有人对其对临床决策的影响持怀疑态度。然而,该软件在管理转诊流程和跟踪患者在其他护理点的进展方面被发现是有效的。

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