The clinician crowdsourcing challenge: using participatory design to seed implementation strategies
The clinician crowdsourcing challenge: using participatory design to seed implementation strategies
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DOI：
10.1186/s13012-019-0914-2
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发表时间：
2019-06-14
影响因子：
7.2
通讯作者：
Beidas, Rinad S.
中科院分区：
文献类型：
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作者：
Stewart, Rebecca E.;Williams, Nathaniel;Beidas, Rinad S.
背景在医疗机构，系统和组织的领导者往往控制的选择和实施策略的设计，即使一线工作人员可能有最亲密的了解的护理提供过程中，优化和限制循证实践的实施在当地系统的因素。创新锦标赛是一种结构化的参与式设计策略，用于众包创意，是一种很有前途的参与式设计方法，可以通过让最终用户（即，临床医生）。我们利用了一个系统范围内的创新锦标赛，从临床医生的想法，如何提高使用循证医学实践（EBP）在一个大型的公共行为health system.MethodsOur创新锦标赛发生在三个阶段。首先，我们邀请了500多名临床医生通过一个基于网络的平台分享他们关于他们的组织如何最好地支持使用EBP的想法。临床医生可以对其他人提交的想法进行评分和评论。其次，提交的作品由一个专家小组（包括行为科学家、系统领导者和付款人）根据他们对这个想法的热情进行评判。第三，我们举行了一个面向社区的活动，在此期间，6名临床医生谁提交获奖的想法提出了他们的战略，以85与会者代表的临床医生和系统和组织leader.ResultsWe的横截面的参与率很高（12.3%），超过两倍的平均率以前的比赛在其他设置进行（5%）。代表38个组织的55名与会者共提出了65项想法。最常见的想法类别涉及培训（42%），融资和补偿（26%），临床医生支持和准备工具（22%）以及以EBP为重点的监督（17%）。专家小组和临床医生不同的想法，他们的评级，突出的价值，寻求从多个利益相关者群体的输入时，制定实施strategies.ConclusionsInnovation锦标赛是一个有用的和可行的方法，通过结构化的方法来开发实施战略的最终用户，系统的领导者，和行为科学家。该过程和由此产生的战略产生了显着的热情和参与者在各级医疗保健系统。需要进行研究，以比较通过创新锦标赛制定的战略，通过设计方法制定的战略的有效性。
BackgroundIn healthcare settings, system and organization leaders often control the selection and design of implementation strategies even though frontline workers may have the most intimate understanding of the care delivery process, and factors that optimize and constrain evidence-based practice implementation within the local system. Innovation tournaments, a structured participatory design strategy to crowdsource ideas, are a promising approach to participatory design that may increase the effectiveness of implementation strategies by involving end users (i.e., clinicians). We utilized a system-wide innovation tournament to garner ideas from clinicians about how to enhance the use of evidence-based practices (EBPs) within a large public behavioral health system.MethodsOur innovation tournament occurred in three phases. First, we invited over 500 clinicians to share, through a web-based platform, their ideas regarding how their organizations could best support use of EBPs. Clinicians could rate and comment on ideas submitted by others. Second, submissions were judged by an expert panel (including behavioral scientists, system leaders, and payers) based on their rated enthusiasm for the idea. Third, we held a community-facing event during which the six clinicians who submitted winning ideas presented their strategies to 85 attendees representing a cross-section of clinicians and system and organizational leaders.ResultsWe had a high rate of participation (12.3%), more than double the average rate of previous tournaments conducted in other settings (5%). A total of 65 ideas were submitted by 55 participants representing 38 organizations. The most common categories of ideas pertained to training (42%), financing and compensation (26%), clinician support and preparation tools (22%), and EBP-focused supervision (17%). The expert panel and clinicians differed on their ratings of the ideas, highlighting value of seeking input from multiple stakeholder groups when developing implementation strategies.ConclusionsInnovation tournaments are a useful and feasible methodology for engaging end users, system leaders, and behavioral scientists through a structured approach to developing implementation strategies. The process and resultant strategies engendered significant enthusiasm and engagement from participants at all levels of a healthcare system. Research is needed to compare the effectiveness of strategies developed through innovation tournaments to strategies developed through design approaches.