Division for Health and Social Sciences, Norwegian Research Centre, Stavanger, Norway.
Department for Dermatology, Stavanger University Hospital, Stavanger, Norway.
JMIR Res Protoc. 2024 Nov 4;13:e55502. doi: 10.2196/55502.
There is a growing prevalence of nonhealing wounds and chronic diseases in society, and there is an associated need for wound management solutions that include the use of telemedicine. A broad spectrum of factors influences the planning and execution of interventions within telemedicine in chronic wound management, spanning organizations, technologies, and individuals, including professionals and patients. The Telemedicine and Ambulatory Wound Care Team (TELE-AMBUS) project applies a whole-system research approach to account for this spectrum of factors.
The primary objective of this study was to explore and analyze the implementation and consequences of an outpatient wound management model, comprising 2 interconnected quality improvement interventions (ie, telemedicine and ambulatory wound care team) aimed at older and vulnerable patients with chronic wounds, across the specialist and primary health care sectors. Embedded in this objective is the aim to improve the competence levels of health care providers and, consequently, the service quality of outpatient wound management across specialist and primary health care services.
This project examines the implementation and consequences of an outpatient wound management model through a combined process and economic evaluation research strategy. A sociotechnical system theory approach and multiple work package design support the examination. The project uses observations, conversations, interviews, and economic assessments to gather rich, in-depth insights and understanding on why and how the new wound management model contributes to a change or not compared with the traditional treatment model.
The project has been funded from 2021 to 2025. Baseline interviews have been conducted since April 2022 and concluded in January 2024. Fieldwork, including nonparticipant observations, semistructured interviews, and informal conversations, has been conducted since November 2022 and is expected to conclude in March 2025. In parallel and as part of the cost-effectiveness analyses, time usage data on the outpatient and regular clinical models are being gathered during the fieldwork.
We applied a whole-system approach in multiple ways, that is, to design or inform our fieldwork and to explore, evaluate, and translate project findings into practice across services. To our knowledge, this approach has not been undertaken in telemedicine in chronic wound management literature and associated human factors and ergonomics research. Thus, our approach can produce both original and novel research and theoretical results internationally.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/55502.
社会中不愈伤口和慢性病的发病率不断上升，因此需要伤口管理解决方案，包括使用远程医疗。远程医疗在慢性伤口管理中的规划和执行受到广泛的因素影响，包括组织、技术和个人，包括专业人员和患者。Telemedicine and Ambulatory Wound Care Team（TELE-AMBUS）项目采用全系统研究方法来考虑这一系列因素。
本研究的主要目的是探讨和分析一种门诊伤口管理模式的实施和后果，该模式包括 2 个相互关联的质量改进干预措施（即远程医疗和门诊伤口护理团队），旨在为患有慢性伤口的老年和脆弱患者提供服务，跨越专科和初级保健部门。这一目标旨在提高医疗保健提供者的能力水平，从而提高专科和初级保健服务的门诊伤口管理服务质量。
本项目通过结合过程和经济评估研究策略来检查门诊伤口管理模式的实施和后果。社会技术系统理论方法和多个工作包设计支持检查。该项目使用观察、对话、访谈和经济评估来收集丰富、深入的见解和理解，了解为什么以及新的伤口管理模式如何与传统治疗模式相比产生变化或没有变化。
该项目从 2021 年到 2025 年获得资助。自 2022 年 4 月以来一直在进行基线访谈，于 2024 年 1 月结束。自 2022 年 11 月以来一直在进行现场工作，包括非参与观察、半结构化访谈和非正式对话，并预计于 2025 年 3 月结束。与此同时，作为成本效益分析的一部分，正在现场工作期间收集门诊和常规临床模型的时间使用数据。
我们以多种方式应用了全系统方法，即设计或为我们的现场工作提供信息，并在服务之间探索、评估和转化项目发现。据我们所知，在远程医疗在慢性伤口管理文献及其相关的人为因素和工效学研究中，尚未采用这种方法。因此，我们的方法可以在国际上产生原创和新颖的研究和理论成果。
国际注册报告标识符（IRRID）：DERR1-10.2196/55502.
