Implementing Rapid Whole-Genome Sequencing in Critical Care: A Qualitative Study of Facilitators and Barriers to New Technology Adoption
Implementing Rapid Whole-Genome Sequencing in Critical Care: A Qualitative Study of Facilitators and Barriers to New Technology Adoption
复制标题
DOI：
10.1016/j.jpeds.2021.05.045
复制
发表时间：
2021-09-22
影响因子：
5.1
通讯作者：
Dimmock, David
中科院分区：
文献类型：
--
作者：
Franck, Linda S.;Kriz, Rebecca M.;Dimmock, David
目的 描述多学科团队成员对实施快速全基因组测序 (rWGS) 作为不同儿童医院环境中危重儿童的一级检测的看法。研究设计 根据实施科学理论，对参与全州 rWGS 实施项目的 5 家三级护理儿童医院的多学科患者护理团队和医院领导进行定性访谈。结果 我们的分析揭示了有关整个实施过程的 5 个关键主题站点：对 rWGS 拥护者的需求、教育需求和策略、谈判决策角色和流程、工作流程和解决方法以及对 rWGS 的看法。根据研究结果，制定了综合临床工作流程图，总结了实施测试所涉及的所有流程，以及实施实践不同的关键领域。 结论 这些研究结果为干预措施的设计提供了见解，以支持 rWGS 和其他新技术在新生儿和儿科重症监护环境中的采用、扩大和可持续性。
Objective To characterize the views of members of the multi-disciplinary team regarding the implementation of rapid whole-genome sequencing (rWGS) as a first- tier test for critically ill children in diverse children's hospital settings.Study design Qualitative interviews informed by implementation science theory were conducted with the multidisciplinary patient care teams and hospital leaders at each of the 5 tertiary care children's hospitals involved in a statewide rWGS implementation project.Results Our analysis revealed 5 key themes regarding the implementation process across the sites: the need for rWGS champions, educational needs and strategies, negotiating decision- making roles and processes, workflows and workarounds, and perceptions about rWGS. From the findings a composite clinical workflow diagram was developed to summarize all of the processes involved in the implementation of the test, and the key areas where implementation practices differed.Conclusions These findings provide insights for design of interventions to support adoption, scale-up, and sustainability of rWGS and other novel technologies in neonatal and pediatric critical care settings.