Applying population health approaches to improve safe anticoagulant use in the outpatient setting: the DOAC Dashboard multi-cohort implementation evaluation study protocol.
Applying population health approaches to improve safe anticoagulant use in the outpatient setting: the DOAC Dashboard multi-cohort implementation evaluation study protocol.
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DOI：
10.1186/s13012-020-01044-5
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发表时间：
2020-09-21
期刊：
影响因子：
--
通讯作者：
Sussman J
中科院分区：
文献类型：
--
作者：
Barnes GD;Sippola E;Dorsch M;Errickson J;Lanham M;Allen A;Spoutz P;Sales AE;Sussman J
直接口服抗凝剂（DOAC）用于治疗心房颤动和静脉血栓栓塞的应用正在迅速增长。然而，这些药物的错误剂量很常见，并使患者面临药物不良事件的风险。改善处方安全的一种方法是使用人口健康工具，包括电子健康记录 (EHR) 中内置的交互式仪表板。随着此类工具变得越来越普遍，探索如何了解哪些方面在特定环境下有效以及如何在不同卫生系统的现有抗凝诊所中有效调整和实施至关重要。这个三阶段项目将使用定量和定性方法评估退伍军人健康管理局 (VHA) 中 DOAC 仪表板当前在全国范围内的实施工作。根据本次评估，DOAC 仪表板将在四个新的卫生系统中实施，采用的实施策略源自 VHA 经验以及对这些新卫生系统中提供者的采访。 VHA 和非 VHA 实施的定量评估将遵循范围、有效性、采用、实施、维护 (RE-AIM) 框架。将使用实施研究综合框架和技术接受模型来分析与利益相关者的定性访谈，以确定实施成功的关键决定因素。本研究将 (1) 评估基于 EHR 的人口健康工具在大型、全国性、高度一体化的卫生系统内进行药物管理的实施情况； (2) 指导四个不同卫生系统的采用； (3)评估多中心实施力度。这些发现将有助于为未来在各种医疗保健环境中基于电子病历的实施工作提供信息。
Use of direct oral anticoagulants (DOAC) is rapidly growing for treatment of atrial fibrillation and venous thromboembolism. However, incorrect dosing of these medications is common and puts patients at risk of adverse drug events. One way to improve safe prescribing is the use of population health tools, including interactive dashboards built into the electronic health record (EHR). As such tools become more common, exploring ways to understand which aspects are effective in specific settings and how to effectively adapt and implement in existing anticoagulation clinics across different health systems is vital. This three-phase project will evaluate a current nation-wide implementation effort of the DOAC Dashboard in the Veterans Health Administration (VHA) using both quantitative and qualitative methods. Informed by this evaluation, the DOAC Dashboard will be implemented in four new health systems using an implementation strategy derived from the VHA experience and interviews with providers in those new health systems. Quantitative evaluation of the VHA and non-VHA implementation will follow the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. Qualitative interviews with stakeholders will be analyzed using the Consolidated Framework for Implementation Research and Technology Acceptance Models to identify key determinants of implementation success. This study will (1) evaluate the implementation of an EHR-based population health tool for medication management within a large, nation-wide, highly integrated health system; (2) guide the adoption in a set of four different health systems; and (3) evaluation that multi-center implementation effort. These findings will help to inform future EHR-based implementation efforts in a wide variety of health care settings.
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影响因子：
12.7
作者：
Glasgow, RE;Vogt, TM;Boles, SM
通讯作者：
Boles, SM
影响因子：
7.2
作者：
DEYO, RA;CHERKIN, DC;CIOL, MA
通讯作者：
CIOL, MA
影响因子：
3.7
作者：
Backman R;Bayliss S;Moore D;Litchfield I
通讯作者：
Litchfield I
DOI：
10.1111/j.1464-0597.2008.00341.x
发表时间：
2008-10-01
影响因子：
7.2
作者：
Michie, Susan;Johnston, Marie;Eccles, Martin
通讯作者：
Eccles, Martin
影响因子：
2.9
作者：
Basaran, Ozcan;Basaran, Nesrin Filiz;Biteker, Murat
通讯作者：
Biteker, Murat