Translating research into clinical practice: Making change happen
Translating research into clinical practice: Making change happen
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DOI：
10.1111/j.1532-5415.2004.52510.x
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发表时间：
2004-11-01
影响因子：
6.3
通讯作者：
Inouye, SK
中科院分区：
文献类型：
--
作者：
Bradley, EH;Schlesinger, M;Inouye, SK
目标：描述在医院环境中采用基于证据的、多方面的创新计划的过程，特别关注促进或阻碍其实施的问题。本研究探讨了实施医院老年生活计划 (HELP) 的医院面临的常见挑战以及用于应对这些挑战的策略。设计：基于深入、开放式电话访谈的定性研究设计。背景：美国各地实施 HELP 的 9 家医院。参与者：直接参与 HELP 实施的 32 名关键工作人员（医生、护理人员、志愿者和行政人员）。衡量：工作人员实施该计划的经验，包括他们认为成功克服的挑战和策略结果：医院工作人员面临六个常见挑战：(1) 尽管管理人员和临床人员的要求和目标不同，但仍获得对该计划的内部支持；(2) 确保有效的临床医生领导；(3) 与现有的老年病计划相结合；(4) 平衡计划的保真度与医院的具体情况；(5) 尽管数据收集和分析的资源有限，但记录计划的积极成果；(6) 在不切实际的时间框架和有限的资源下保持实施的势头。描述了被认为可以成功应对每个挑战的策略。结论：将研究转化为临床实践对于跨学科的工作人员来说是一项挑战。制定策略来解决本研究中发现的常见挑战可能会促进医疗保健组织内创新计划的采用。
Objectives: To describe the process of adoption of an evidence-based, multifaceted, innovative program into the hospital setting, with particular attention to issues that promoted or impeded its implementation. This study examined common challenges faced by hospitals implementing the Hospital Elder Life Program (HELP) and strategies used to address these challenges.Design: Qualitative study design based on in-depth, open-ended telephone interviews.Setting: Nine hospitals implementing HELP throughout the United States.Participants: Thirty-two key staff members (physician, nursing, volunteer, and administrative staff) who were directly involved with the HELP implementation.Measurements: Staff experiences implementing the program, including challenges and strategies they viewed as successful in overcoming challenges of implementation.Results: Six common challenges faced hospital staff: (1) gaining internal support for the program despite differing requirements and goals of administration and clinical staff, (2) ensuring effective clinician leadership, (3) integrating with existing geriatric programs, (4) balancing program fidelity with hospital-specific circumstances, (5) documenting positive outcomes of the program despite limited resources for data collection and analysis, and (6) maintaining the momentum of implementation in the face of unrealistic time frames and limited resources. Strategies perceived to be successful in addressing each challenge are described.Conclusion: Translating research into clinical practice is challenging for staff across disciplines. Developing strategies to address common challenges identified in this study may facilitate the adoption of innovative programs within healthcare organizations.