What are the key contextual factors when preparing for successful implementation of assistive living technology in primary elderly care? A case study from Norway.
What are the key contextual factors when preparing for successful implementation of assistive living technology in primary elderly care? A case study from Norway.
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DOI：
10.1136/bmjopen-2016-015455
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发表时间：
2017-09-07
期刊：
影响因子：
2.9
通讯作者：
Testad I
中科院分区：
文献类型：
--
作者：
Gjestsen MT;Wiig S;Testad I
识别不同组织层面的背景因素，以指导在挪威初级家庭护理中实施辅助生活技术干预。在挪威西部的一个城市进行了一个单一的嵌入式案例研究设计，从市政当局的角度来概述关键的背景因素。数据收集是基于一个三角的方法，包括文件分析，半结构化的个人访谈和焦点小组访谈，以获得广泛的洞察力时，准备干预。收集了三个层次的医疗保健系统的数据：（1）国家政策文件和法规（宏观），（2）五个单独采访的高级管理人员和市政战略文件（中观）和（3）两个焦点小组采访护士和护士管理人员在直接病人护理（微观）。在数据分析中，使用了理解质量成功的模型框架作为指导。确定的主要背景因素是外部激励因素和项目赞助（宏观层面）;领导、工作人员的重点和成熟度（中观层面）;以及变革的动力和成熟度（微观层面）。政策文件中制定的战略影响了市政当局的高层管理，但微观层面的医疗保健人员对辅助生活技术的战略和重点并不熟悉。我们研究中的医疗保健人员有动力使用技术解决方案，但缺乏数据基础设施和资源可用性阻碍了这一点。在规划初级保健中的辅助生活技术干预时，协调多个利益相关者的利益仍然是一个挑战。在所研究的城市，技术解决方案整合到医疗保健服务更多的是一个愿景，而不是现实，因为组织准备水平低。
To identify contextual factors at different organisational levels to guide the implementation of an assistive living technology intervention in Norwegian primary home care. A single embedded case study design was carried out in an urban municipality in Western Norway to get an overview of key contextual factors from the municipality’s perspective. The data collection was based on a triangulation of methods involving document analysis, semi-structured individual interviews and focus group interviews to get a broad insight when preparing for an intervention. Data were collected on three levels of the healthcare system: (1) national policy documents and regulations (macro), (2) five individual interviews with senior managers and municipal strategy documents (meso) and (3) two focus group interviews with nurses and nurse managers in direct patient care (micro). The Model for Understanding Success in Quality framework was used as a guide in the data analysis. The main contextual factors identified were external motivators and project sponsorship (macro level); leadership, workforce focus and maturity (meso level);and motivation to change and maturity (micro level). Strategies developed in policy documents affected upper management in the municipality, but healthcare personnel at the micro level were not so familiar with strategies and emphasis on assistive living technologies. Healthcare personnel in our study were motivated to use technological solutions, but lack of data infrastructure and resource availability hindered this. Aligning interests across multiple stakeholders remain a challenge when planning for an assistive living technology intervention in primary care. In the studied municipality, integration of technological solutions into healthcare services was more a vision than a reality because of a low level of organisational readiness.
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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
DOI：
10.1016/j.ijmedinf.2013.10.009
发表时间：
2014-07-01
影响因子：
4.9
作者：
Abbott, Patricia A.;Foster, Joanne;Dykes, Patricia C.
通讯作者：
Dykes, Patricia C.
影响因子：
9.3
作者：
Greenhalgh T;Procter R;Wherton J;Sugarhood P;Hinder S;Rouncefield M
通讯作者：
Rouncefield M
影响因子：
2.8
作者：
Hovlid, Einar;Bukve, Oddbjorn
通讯作者：
Bukve, Oddbjorn
影响因子：
2.5
作者：
Kaplan, Heather C.;Froehle, Craig M.;Margolis, Peter A.
通讯作者：
Margolis, Peter A.