基于网站的卫生专业人员质量改进工具的实用性:系统性综述。

IF 2.7 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES International Journal for Quality in Health Care Pub Date : 2024-07-26 DOI:10.1093/intqhc/mzae068
Georgie Tran, Bridget Kelly, Megan Hammersley, Jennifer Norman, Anthony Okely
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引用次数: 0

摘要

背景:随着技术的不断进步,了解基于网站的工具如何支持质量改进非常重要。网站工具是指用户可以通过专用网站自主访问和使用的工具包等资源。本综述研究了基于网站的工具如何为医疗保健专业人员的质量改进提供支持,包括开发工具的最佳流程和有效工具的要素:方法:对七个数据库进行了系统检索,以纳入 2012 年 1 月至 2024 年 1 月间发表的文章。这些文章必须经过同行评审、以英语撰写、基于医疗机构并报道了为专业人员开发或评估基于质量改进网站的工具的情况。使用 NVivo 进行了叙述性综合。使用混合方法评估工具对偏倚风险进行了评估。所有论文均由两位作者使用 Braun 和 Clarke 提出的六阶段概念框架进行独立筛选和编码:结果:18 项研究符合纳入标准。确定的主题包括工具开发流程、质量改进机制以及工具使用的障碍和促进因素。现有质量改进流程数字化(7 项)、发现实践中的差距(6 项)和促进专业发展(3 项)是常见的质量改进目标。据报告,这些工具提高了临床任务的准确性和效率,改善了对指南的遵守情况,促进了反思性实践,并为持续质量改进提供了有针对性的反馈。其共同特点是提供教育资源(7 项)和协助用户根据标准/建议评估当前实践(6 项),从而帮助专业人员取得更好的临床效果、提高专业满意度并简化各种环境下的工作流程。研究报告称,工具使用的促进因素包括与实践的相关性、易用性和促进多学科行动,这使得这些工具对医疗保健来说既实用又省时。不过,也有研究报告指出,这些工具存在耗时、与实践无关、难以使用和缺乏组织参与等障碍。几乎所有工具都是与利益相关者共同开发的。共同设计方法各不相同,反映了利益相关者参与和采用共同设计方法的不同程度。值得注意的是,纳入研究的质量不高:这些发现为今后开发基于网站的医疗质量改进工具提供了宝贵的启示。建议包括确保与医疗保健专业人员共同开发工具,关注实际可用性并解决常见障碍,以提高参与度和改善医疗保健质量的有效性。需要进行随机对照试验,以提供工具有效性的客观证据:这项工作得到了澳大利亚新南威尔士州卫生部资助的预防研究支持计划的支持:本综述已在 PROSPERO 注册,注册号:CRD42023451346。CRD42023451346。
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The utility of website-based quality improvement tools for health professionals: a systematic review.

As technology continues to advance, it is important to understand how website-based tools can support quality improvement. Website-based tools refer to resources such as toolkits that users can access and use autonomously through a dedicated website. This review examined how website-based tools can support healthcare professionals with quality improvement, including the optimal processes used to develop tools and the elements of an effective tool. A systematic search of seven databases was conducted to include articles published between January 2012 and January 2024. Articles were included if they were peer reviewed, written in English, based in health settings, and reported the development or evaluation of a quality improvement website-based tool for professionals. A narrative synthesis was conducted using NVivo. Risk of bias was assessed using the Mixed Methods Appraisal Tool. All papers were independently screened and coded by two authors using a six-phase conceptual framework by Braun and Clarke. Eighteen studies met the inclusion criteria. Themes identified were tool development processes, quality improvement mechanisms and barriers and facilitators to tool usage. Digitalizing existing quality improvement processes (n = 7), identifying gaps in practice (n = 6), and contributing to professional development (n = 3) were common quality improvement aims. Tools were associated with the reported enhancement of accuracy and efficiency in clinical tasks, improvement in adherence to guidelines, facilitation of reflective practice, and provision of tailored feedback for continuous quality improvement. Common features were educational resources (n = 7) and assisting the user to assess current practices against standards/recommendations (n = 6), which supported professionals in achieving better clinical outcomes, increased professional satisfaction and streamlined workflow in various settings. Studies reported facilitators to tool usage including relevance to practice, accessibility, and facilitating multidisciplinary action, making these tools practical and time-efficient for healthcare. However, barriers such as being time consuming, irrelevant to practice, difficult to use, and lack of organizational engagement were reported. Almost all tools were co-developed with stakeholders. The co-design approaches varied, reflecting different levels of stakeholder engagement and adoption of co-design methodologies. It is noted that the quality of included studies was low. These findings offer valuable insights for future development of quality improvement website-based tools in healthcare. Recommendations include ensuring tools are co-developed with healthcare professionals, focusing on practical usability and addressing common barriers to enhance engagement and effectiveness in improving healthcare quality. Randomized controlled trials are warranted to provide objective evidence of tool efficacy.

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来源期刊
CiteScore
4.90
自引率
3.80%
发文量
87
审稿时长
6-12 weeks
期刊介绍: The International Journal for Quality in Health Care makes activities and research related to quality and safety in health care available to a worldwide readership. The Journal publishes papers in all disciplines related to the quality and safety of health care, including health services research, health care evaluation, technology assessment, health economics, utilization review, cost containment, and nursing care research, as well as clinical research related to quality of care. This peer-reviewed journal is truly interdisciplinary and includes contributions from representatives of all health professions such as doctors, nurses, quality assurance professionals, managers, politicians, social workers, and therapists, as well as researchers from health-related backgrounds.
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