Refining Expert Recommendations for Implementing Change (ERIC) strategy surveys using cognitive interviews with frontline providers.
Refining Expert Recommendations for Implementing Change (ERIC) strategy surveys using cognitive interviews with frontline providers.
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DOI：
10.1186/s43058-023-00409-3
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发表时间：
2023-04-21
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《实施变革的专家建议》汇编包括73项明确的实施战略，分为9个内容领域。这一分类法已被用于通过调查跟踪一段时间内的实施战略。本研究的目的是改善ERIC调查使用认知访谈与非执行科学家临床医生。从2015年开始，我们开发并开展了年度ERIC调查，以评估退伍军人健康管理局（VA）的肝脏护理。我们邀请已完成至少三项调查的供应商参与认知访谈（2020年10月至2021年10月）。在访谈之前，参与者回顾了完整的73项ERIC调查，并标记了哪些策略由于措辞、概念混淆或与其他策略重叠而不清楚。然后，他们进行了半结构化的认知访谈，以描述完成调查的经验，并详细说明哪些策略需要进一步澄清。12名VA提供者完成了认知访谈调查。“吸引消费者”和“支持临床医生”集群在概念和措辞清晰度方面得分最高。相比之下，“金融”组的措辞和概念最混乱。“因地制宜”集群战略被认为具有最大的冗余性。提供者概述了如何在措辞（32%），概念清晰度（51%）和澄清战略之间的区别（51%）方面使战略更加清晰。对ERIC调查参与者的认知访谈使我们能够识别和解决策略措辞的问题，联合收割机结合概念上模糊的策略，并分解多管策略。根据这些发现对ERIC调查所做的改进将最终帮助VA和其他机构设计，评估和复制质量改进工作。 在线版本包含补充材料，可通过10.1186/s43058-023-00409-3获得。
The Expert Recommendations for Implementing Change (ERIC) compilation includes 73 defined implementation strategies clustered into nine content areas. This taxonomy has been used to track implementation strategies over time using surveys. This study aimed to improve the ERIC survey using cognitive interviews with non-implementation scientist clinicians. Starting in 2015, we developed and fielded annual ERIC surveys to evaluate liver care in the Veterans Health Administration (VA). We invited providers who had completed at least three surveys to participate in cognitive interviews (October 2020 to October 2021). Before the interviews, participants reviewed the complete 73-item ERIC survey and marked which strategies were unclear due to wording, conceptual confusion, or overlap with other strategies. They then engaged in semi-structured cognitive interviews to describe the experience of completing the survey and elaborate on which strategies required further clarification. Twelve VA providers completed surveys followed by cognitive interviews. The “Engage Consumer” and “Support Clinicians” clusters were rated most highly in terms of conceptual and wording clarity. In contrast, the “Financial” cluster had the most wording and conceptual confusion. The “Adapt and Tailor to Context” cluster strategies were considered to have the most redundancy. Providers outlined ways in which the strategies could be clearer in terms of wording (32%), conceptual clarity (51%), and clarifying the distinction between strategies (51%). Cognitive interviews with ERIC survey participants allowed us to identify and address issues with strategy wording, combine conceptually indistinct strategies, and disaggregate multi-barreled strategies. Improvements made to the ERIC survey based on these findings will ultimately assist VA and other institutions in designing, evaluating, and replicating quality improvement efforts. The online version contains supplementary material available at 10.1186/s43058-023-00409-3.