Exploring the interpersonal-, organization-, and system-level factors that influence the implementation and use of an innovation-synoptic reporting-in cancer care.
Exploring the interpersonal-, organization-, and system-level factors that influence the implementation and use of an innovation-synoptic reporting-in cancer care.
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DOI：
10.1186/1748-5908-7-12
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发表时间：
2012-03-01
期刊：
影响因子：
--
通讯作者：
Sargeant J
中科院分区：
文献类型：
--
作者：
Urquhart R;Porter GA;Grunfeld E;Sargeant J
报告诊断和外科手术结果的主要方法是叙述性报告。在癌症护理中，该报告不一致地提供了了解癌症并做出知情的患者护理决策所需的信息。另一种报告方法是概要报告，它以结构化的方式捕获特定的数据项，并且只包含对患者护理至关重要的项目。研究表明，天气报告大大提高了报告的质量。然而，概要报告代表了癌症护理的一项复杂创新，其实施和使用需要医生行为和实践的根本转变，以及组织和更大系统的支持。本研究的目的是探讨关键的人际，组织和系统层面的因素，影响实施和使用的概要报告在癌症护理。这项研究涉及加拿大新斯科舍省的三项举措，这些举措在其部门/方案中实施了天气报告。案例研究方法将用于深入研究这些举措（案例），探索哪些因素是实施和使用的障碍或促进因素，检查因素之间的关系，并发现哪些因素在案例中相似和不同。选择这些案例是因为它们在可能影响实践中实施和使用创新的因素方面既有相同之处，又有不同之处。将通过深入访谈、文件分析、观察培训课程以及审查/使用概要报告工具来收集数据。将进行稽查以确定/量化使用情况。分析将涉及为每个案件制作案件记录/历史，深入分析每个案件，以及跨案件分析，其中调查结果将在案件之间进行比较和对比，以开发理论上知情的，可推广的知识，可应用于其他环境/背景。本研究获得了伦理批准。这项研究将有助于我们的知识基础上的多层次因素，以及在特定情况下的因素之间的关系，影响实施和使用的创新，如天气报告在医疗保健。这些知识对于提高我们对临床环境中实施过程的理解，以及帮助研究人员，临床医生和管理人员/管理人员开发和实施更有效地将创新整合到常规临床护理中的方法至关重要。
The dominant method of reporting findings from diagnostic and surgical procedures is the narrative report. In cancer care, this report inconsistently provides the information required to understand the cancer and make informed patient care decisions. Another method of reporting, the synoptic report, captures specific data items in a structured manner and contains only items critical for patient care. Research demonstrates that synoptic reports vastly improve the quality of reporting. However, synoptic reporting represents a complex innovation in cancer care, with implementation and use requiring fundamental shifts in physician behaviour and practice, and support from the organization and larger system. The objective of this study is to examine the key interpersonal, organizational, and system-level factors that influence the implementation and use of synoptic reporting in cancer care. This study involves three initiatives in Nova Scotia, Canada, that have implemented synoptic reporting within their departments/programs. Case study methodology will be used to study these initiatives (the cases) in-depth, explore which factors were barriers or facilitators of implementation and use, examine relationships amongst factors, and uncover which factors appear to be similar and distinct across cases. The cases were selected as they converge and differ with respect to factors that are likely to influence the implementation and use of an innovation in practice. Data will be collected through in-depth interviews, document analysis, observation of training sessions, and examination/use of the synoptic reporting tools. An audit will be performed to determine/quantify use. Analysis will involve production of a case record/history for each case, in-depth analysis of each case, and cross-case analysis, where findings will be compared and contrasted across cases to develop theoretically informed, generalisable knowledge that can be applied to other settings/contexts. Ethical approval was granted for this study. This study will contribute to our knowledge base on the multi-level factors, and the relationships amongst factors in specific contexts, that influence implementation and use of innovations such as synoptic reporting in healthcare. Such knowledge is critical to improving our understanding of implementation processes in clinical settings, and to helping researchers, clinicians, and managers/administrators develop and implement ways to more effectively integrate innovations into routine clinical care.
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DOI：
10.1016/0749-5978(91)90020-t
发表时间：
1991-12-01
影响因子：
4.6
作者：
AJZEN, I
通讯作者：
AJZEN, I
影响因子：
120.7
作者：
Bradley, EH;Holmboe, ES;Krumholz, HM
通讯作者：
Krumholz, HM
影响因子：
3.8
作者：
Chambers, Anthony J.;Pasieka, Janice L.;Temple, Walley J.
通讯作者：
Temple, Walley J.
影响因子：
8.4
作者：
Branston, LK;Greening, S;Williams, GT
通讯作者：
Williams, GT
影响因子：
3.4
作者：
Bull, AD;Biffin, AHB;Williams, GT
通讯作者：
Williams, GT