A picture is worth a thousand words: advancing the use of visualization tools in implementation science through process mapping and matrix heat mapping.
A picture is worth a thousand words: advancing the use of visualization tools in implementation science through process mapping and matrix heat mapping.
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DOI：
10.1186/s43058-023-00424-4
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发表时间：
2023-04-25
影响因子：
--
通讯作者：
Cragun, Deborah
中科院分区：
文献类型：
--
作者：
Salvati, Zachary M.;Rahm, Alanna Kulchak;Williams, Marc S.;Ladd, Ilene;Schlieder, Victoria;Atondo, Jamie;Schneider, Jennifer L.;Epstein, Mara M.;Lu, Christine Y.;Pawloski, Pamala A.;Sharaf, Ravi N.;Liang, Su-Ying;Burnett-Hartman, Andrea N.;Hunter, Jessica Ezzell;Burton-Akright, Jasmine;Cragun, Deborah
关键词：
确定关键的决定因素是至关重要的，以改善计划的实施和实现医疗机构内的长期可持续发展。跨多个利益相关者的企业级复杂性和异质性会使我们对计划实施的理解变得复杂。我们描述了两种数据可视化方法，用于操作化实施成功，并巩固和选择实施因素进行进一步分析。我们使用过程映射和矩阵热图的组合，系统地综合和可视化来自9个医疗机构的66个利益相关者访谈的定性数据，以描述所有新诊断的结直肠癌和子宫内膜癌的通用肿瘤筛查计划，并了解环境因素对实施的影响。我们构建了协议的可视化表示，以比较流程并对流程优化组件进行评分。我们还使用颜色编码矩阵系统地编码，总结和整合上下文数据，使用实施研究综合框架（CFIR）的因素。在最终数据矩阵热图中可视化组合评分。创建了19个过程图，以直观地表示每个方案。流程图确定了以下差距和效率低下：方案执行不一致，没有常规反射测试，阳性筛选后转诊不一致，没有数据跟踪证据，缺乏质量保证措施。患者护理中的这些障碍帮助我们定义了五个流程优化组件，并使用这些组件来量化从0（无程序）到5（优化）的程序优化，代表程序实施和最佳维护的程度。最终数据矩阵热图中的综合得分揭示了优化计划、非优化计划和没有计划的组织中的上下文因素模式。流程映射提供了一种有效的方法，可以直观地比较各个站点之间的流程，包括患者流量、提供者互动以及流程差距和效率低下，从而通过优化分数衡量实施成功与否。矩阵热图被证明对数据可视化和整合有用，从而产生了用于跨站点比较和选择相关CFIR因子的汇总矩阵。结合这些工具，使一个系统的和透明的方法来理解复杂的组织异质性之前，正式的巧合分析，介绍了一个逐步的方法来整合数据和因素选择。 在线版本包含补充材料，可通过10.1186/s43058-023-00424-4获得。
Identifying key determinants is crucial for improving program implementation and achieving long-term sustainment within healthcare organizations. Organizational-level complexity and heterogeneity across multiple stakeholders can complicate our understanding of program implementation. We describe two data visualization methods used to operationalize implementation success and to consolidate and select implementation factors for further analysis. We used a combination of process mapping and matrix heat mapping to systematically synthesize and visualize qualitative data from 66 stakeholder interviews across nine healthcare organizations, to characterize universal tumor screening programs of all newly diagnosed colorectal and endometrial cancers and understand the influence of contextual factors on implementation. We constructed visual representations of protocols to compare processes and score process optimization components. We also used color-coded matrices to systematically code, summarize, and consolidate contextual data using factors from the Consolidated Framework for Implementation Research (CFIR). Combined scores were visualized in a final data matrix heat map. Nineteen process maps were created to visually represent each protocol. Process maps identified the following gaps and inefficiencies: inconsistent execution of the protocol, no routine reflex testing, inconsistent referrals after a positive screen, no evidence of data tracking, and a lack of quality assurance measures. These barriers in patient care helped us define five process optimization components and used these to quantify program optimization on a scale from 0 (no program) to 5 (optimized), representing the degree to which a program is implemented and optimally maintained. Combined scores within the final data matrix heat map revealed patterns of contextual factors across optimized programs, non-optimized programs, and organizations with no program. Process mapping provided an efficient method to visually compare processes including patient flow, provider interactions, and process gaps and inefficiencies across sites, thereby measuring implementation success via optimization scores. Matrix heat mapping proved useful for data visualization and consolidation, resulting in a summary matrix for cross-site comparisons and selection of relevant CFIR factors. Combining these tools enabled a systematic and transparent approach to understanding complex organizational heterogeneity prior to formal coincidence analysis, introducing a stepwise approach to data consolidation and factor selection. The online version contains supplementary material available at 10.1186/s43058-023-00424-4.
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使用综合医疗保健系统中的通用肿瘤筛查程序鉴定患有林奇综合征的患者。
影响因子：
1.7
作者：
Crain, Philip R.;Zepp, Jamilyn M.;Gille, Sara;Jenkins, Lindsay;Kauffman, Tia L.;Shuster, Elizabeth;Goddard, Katrina A. B.;Wilfond, Benjamin S.;Hunter, Jessica Ezzell
通讯作者：
Hunter, Jessica Ezzell
影响因子：
--
作者：
Hao J;Hassen D;Gudgeon JM;Snyder SR;Hampel H;Williams MS;Sharaf RN;Lu CY;Williams JL;Schlieder V;Rahm AK
通讯作者：
Rahm AK
影响因子：
7.2
作者：
通讯作者：
--
影响因子：
6.2
作者：
Hunter, Jessica Ezzell;Zepp, Jamilyn M.;Goddard, Katrina A. B.
通讯作者：
Goddard, Katrina A. B.
比较普遍的林奇综合征肿瘤筛查计划，评估实施策略与患者随访之间的关系
影响因子：
8.8
作者：
Cragun, Deborah;DeBate, Rita D.;Pal, Tuya
通讯作者：
Pal, Tuya