Changing Antibiotic Prescribing in a Primary Care Network: The Role of Readiness to Change and Group Dynamics in Success.
Changing Antibiotic Prescribing in a Primary Care Network: The Role of Readiness to Change and Group Dynamics in Success.
复制标题
DOI：
10.1177/1062860617716541
复制
发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Werner RM
中科院分区：
文献类型：
--
作者：
Elango S;Szymczak JE;Bennett IM;Beidas RS;Werner RM
在门诊儿科中，广谱抗生素的过度使用仍然是一个重大问题，关于如何有效实施门诊管理干预措施的证据有限。本研究探讨了准备改变和影响初级保健网络抗生素管理干预成功的可修改因素之间的关系。一项旨在衡量接受医疗保健创新的准备程度的调查对209名临床医生进行了管理。实践被分为“高”和“低”的变化准备。半结构化的定性访谈进行了2至3名临床医生从6个做法，在每个准备组。高准备度实践在几年之间有更大的改善趋势（8%至26% vs 2%至10%的平均改善）。高准备实践临床医生描述了更开放的沟通，积极的群体变化过程，和支持性的潜在群体凝聚力。低准备实践临床医生更独立地运作，更多地受到外部力量的影响，但通过主动发展群体凝聚力。全系统的干预措施应适当适应不同的变革意愿水平，特别是针对群体动态及其不同的影响焦点。
Overuse of broad-spectrum antibiotics in outpatient pediatrics remains a significant issue and there is limited evidence on how to effectively implement outpatient stewardship interventions. This study examines the relationship between readiness to change and modifiable factors affecting success of a primary care network antibiotic stewardship intervention. A survey designed to measure readiness to accept a health care innovation was administered to 209 clinicians. Practices were split in half into “high” versus “low” readiness to change. Semistructured qualitative interviews were conducted with 2 to 3 clinicians from 6 practices in each readiness group. High readiness practices trended toward greater improvements between years (8% to 26% vs 2% to 10% mean improvement). High readiness practice clinicians described more open communication, active group change process, and supportive underlying group cohesion. Low readiness practice clinicians functioned more independently and were influenced more by external forces but were developing group cohesion through the initiative. System-wide interventions should be appropriately tailored to different levels of readiness to change, specifically addressing group dynamics and their differing foci of influence.
登录
查看更多内容
DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
影响因子：
120.7
作者：
Gerber, Jeffrey S.;Prasad, Priya A.;Zaoutis, Theoklis E.
通讯作者：
Zaoutis, Theoklis E.
DOI：
10.1186/1748-5908-5-46
发表时间：
2010-06-14
期刊：
Implementation science : IS
影响因子：
--
作者：
Hagedorn HJ;Heideman PW
通讯作者：
Heideman PW
DOI：
10.1007/s11414-015-9475-6
发表时间：
2017-04
期刊：
The journal of behavioral health services & research
影响因子：
--
作者：
Powell BJ;Beidas RS;Lewis CC;Aarons GA;McMillen JC;Proctor EK;Mandell DS
通讯作者：
Mandell DS
影响因子：
8
作者：
Hersh, Adam L.;Shapiro, Daniel J.;Shah, Samir S.
通讯作者：
Shah, Samir S.