Identifying Strategies to Reduce Missed Opportunities for HPV Vaccination in Primary Care: A Qualitative Study of Positive Deviants.
Identifying Strategies to Reduce Missed Opportunities for HPV Vaccination in Primary Care: A Qualitative Study of Positive Deviants.
复制标题
确定减少初级保健中 HPV 疫苗接种机会错失的策略：正偏差的定性研究。
DOI：
10.1177/0009922820930357
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发表时间：
2020
影响因子：
1.6
通讯作者：
Szilagyi,PeterG
中科院分区：
文献类型：
--
作者：
Rand,CynthiaM;Concannon,Cathleen;Wallace-Brodeur,Rachel;Davis,Wendy;Albertin,ChristinaS;Humiston,SharonG;Szilagyi,PeterG
这项研究的目的是评估在提高人乳头状瘤病毒(HPV)疫苗接种率的国家质量改进(QI)项目期间实施的干预措施的背景因素、实践策略和可持续性。我们进行了半结构化访谈，采用了积极的异常做法，成功地将前一年错失的人乳头瘤病毒疫苗接种机会减少了≥20%。我们评估了领导力支持、激励因素、使用的干预措施和可持续性。与QI团队相关的关键主题包括强大的领导支持、多学科团队、拥有实践冠军以及协作环境。与干预相关的主题包括在11岁时对所有适当的疫苗使用推定捆绑推荐、就诊前规划和预防性就诊提醒，这些做法在干预后1年内对大多数做法都是可持续的。内部实践层面的因素(多学科团队、协作和访问前规划)和组织因素(机构支持和卫生系统层面的预防性访问提醒)都是成功实施QI干预以改善HPV疫苗接种的关键。
The objectives of this study were to assess the contextual factors, practice strategies, and sustainability of interventions implemented during a national quality improvement (QI) project to raise human papillomavirus (HPV) vaccination rates. We conducted semistructured interviews with positive deviant practices that successfully reduced missed opportunities by ≥20% for HPV vaccination in the prior year. We assessed leadership support, motivators, interventions used, and sustainability. Key themes related to QI teams included strong leadership support, multidisciplinary teams, having a practice champion, and a collaborative environment. Themes related to the interventions included using a presumptive bundled recommendation for all appropriate vaccines at age 11, previsit planning, and reminders for preventive visits, which were sustainable for most practices 1-year postintervention. Both internal practice-level factors (multidisciplinary teams, collaboration, and previsit planning) and organizational factors (institutional support and health system–level reminders for preventive visits) were key to a successful QI intervention to improve HPV vaccination.