Informing Proactive integrated virtual healthcare resource use in primary care.
Informing Proactive integrated virtual healthcare resource use in primary care.
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DOI：
10.1186/s12913-021-06783-9
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发表时间：
2021-08-12
影响因子：
2.8
通讯作者：
Zilka B
中科院分区：
文献类型：
--
作者：
Haun JN;Cotner BA;Melillo C;Panaite V;Messina W;Patel-Teague S;Zilka B
积极主动地使用集成虚拟医疗资源(VHR)可以提高效率、最大化资源容量以提供最佳的协调护理，并改善患者结果。积极主动地综合使用VHR对于提供高质量的护理至关重要。我们的目标是在初级保健团队中确定积极主动的综合VHR使用，最佳实践和有针对性的实施战略，以促进积极的综合VHR使用。这是一项混合方法的描述性研究。我们采用了以社区为基础的参与式方法来收集数据，并采用了执行研究综合框架来分析和确定研究结果。来自退伍军人事务部医疗中心的初级保健团队成员的横断面样本(n= 65)参加了焦点小组、后续访谈(n= 16)，并对自我报告调查做出回应。业务主题专家(n= 15)参加了线人访谈。调查数据描述了目前的使用情况和影响单独使用VHR的因素，并与定性结果一致。焦点小组和访谈数据没有描述主动综合使用VHR的证据。两个利用组之间的差异和相似之处被确定，如促进者和障碍、建议、患者教育和首选的实施策略。所有小组都报告了有关VHR可用性、知识以及访问和功能的问题。与会者指出，需要针对护理任务和业绩衡量的最佳做法。专家线人采访确定了一系列VHR工具，这些工具可以在整个医疗保健系统中主动集成。卫生系统正在利用技术主动整合VHR，以最大限度地实现信息交换、临床决策支持和患者参与。在新冠肺炎等全球大流行期间，在遵守公共卫生建议的同时，维持获得护理协调和提供服务的机会，VHR至关重要。虽然最近对减少接触的要求产生了内在的动机，但需要通过教育和跨医疗保健连续系统主动集成使用的最佳实践来改变文化，以创造VHR超级用户的文化。网上版载有补充材料，可在10.1186/s12913-021-06783-9查阅。
Proactive integrated virtual healthcare resource (VHR) use can improve efficiency, maximize resource capacity for delivering optimal coordinated care and improve patient outcomes. Proactive integrated VHR use is vital for delivering high quality care. Our objectives were to identify proactive integrated VHR use among primary care teams, best practices and targeted implementation strategies to promote proactive integrated VHR use. This is a mixed-method descriptive study. We employed a community-based participatory approach to collect data and the Consolidated Framework for Implementation Research to analyze and contextualize findings. A cross-sectional sample of primary care team members (n = 65) from a Department of Veterans Affairs medical center participated in focus groups, follow-up interviews (n = 16), and respond to self-report surveys. Operational subject matter experts (n = 15) participated in informant interviews. Survey data described current use and factors that influenced singular VHR use and were convergent with qualitative findings. Focus group and interview data described no evidence of proactive integrated VHR use. Differences and similarities were identified between both utilization groups, such as facilitators and barriers, recommendations, patient education and preferred implementation strategies. All groups reported issues around VHR availability knowledge and access and functionality. Participants identified the need for best practices that are specific to care tasks and performance measures. Expert informant interviews identified a list of VHR tools that could be proactively integrated across the healthcare continuum. Health systems are leveraging technologies to proactively integrate VHR to maximize information exchange, clinical decision support and patient engagement. VHR is critical during global pandemics, such as COVID-19, to maintain access to care coordination and delivery while abiding by public health recommendations. Though recent requirements for reducing contact create an intrinsic motivation, cultural change through education and best practices of proactive integrated use across the healthcare continuum is needed to create a culture of VHR super users. The online version contains supplementary material available at 10.1186/s12913-021-06783-9.
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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：
1.7
作者：
Haun J;Chavez M;Hathaway W;Antinori N;Melillo C;Cotner BA;McMahon-Grenz J;Zilka B;Patel-Teague S;Messina W;Nazi K
通讯作者：
Nazi K
影响因子：
4.4
作者：
Arndt, Brian G.;Beasley, John W.;Gilchrist, Valerie J.
通讯作者：
Gilchrist, Valerie J.
影响因子：
3.5
作者：
Ancker JS;Edwards A;Nosal S;Hauser D;Mauer E;Kaushal R;with the HITEC Investigators
通讯作者：
with the HITEC Investigators
影响因子：
3.8
作者：
Elo, Satu;Kyngaes, Helvi
通讯作者：
Kyngaes, Helvi