Measurement of a model of implementation for health care: toward a testable theory
Measurement of a model of implementation for health care: toward a testable theory
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DOI：
10.1186/1748-5908-7-59
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发表时间：
2012-07-03
影响因子：
7.2
通讯作者：
Schnurr, Paula P.
中科院分区：
文献类型：
--
作者：
Cook, Joan M.;O'Donnell, Casey;Schnurr, Paula P.
背景资料：Greenhalgh等人使用了大量的证据基础来开发医疗保健组织实施创新的综合模型[1]。然而，这些作者并没有完全操作他们的模型，使其难以正式测试。本文件是在操作Greenhalgh等人的第一步。的模型，提供背景，理论基础，工作定义，和测量的关键constructs.Methods：进行了系统的文献综述的关键词代表53个独立的子结构，从6个模型的广泛的结构。使用迭代过程，我们审查了现有的措施，并利用或调整项目。在没有一个措施被认为是适当的，我们开发了其他项目来衡量的结构通过consensus.Results：团队共识的审查和迭代过程中确定了三种类型的数据，可以用来操作的模型中的结构：调查项目，访谈问题，和行政数据。每个这些的具体例子reported.Conclusion：尽管存在局限性，混合方法的方法来测量使用的调查，访谈措施，和行政数据可以促进研究的实施，提供调查人员的测量工具，捕捉大多数的结构确定的Greenhalgh模型。这些措施目前正被用来收集有关两个循证心理疗法的执行情况的数据，在退伍军人事务部内在全国范围内传播。心理测量特性的测试和随后的改进应提高措施的效用。
Background: Greenhalgh et al. used a considerable evidence-base to develop a comprehensive model of implementation of innovations in healthcare organizations [1]. However, these authors did not fully operationalize their model, making it difficult to test formally. The present paper represents a first step in operationalizing Greenhalgh et al.'s model by providing background, rationale, working definitions, and measurement of key constructs.Methods: A systematic review of the literature was conducted for key words representing 53 separate subconstructs from six of the model's broad constructs. Using an iterative process, we reviewed existing measures and utilized or adapted items. Where no one measure was deemed appropriate, we developed other items to measure the constructs through consensus.Results: The review and iterative process of team consensus identified three types of data that can been used to operationalize the constructs in the model: survey items, interview questions, and administrative data. Specific examples of each of these are reported.Conclusion: Despite limitations, the mixed-methods approach to measurement using the survey, interview measure, and administrative data can facilitate research on implementation by providing investigators with a measurement tool that captures most of the constructs identified by the Greenhalgh model. These measures are currently being used to collect data concerning the implementation of two evidence-based psychotherapies disseminated nationally within Department of Veterans Affairs. Testing of psychometric properties and subsequent refinement should enhance the utility of the measures.