TY - JOUR AU - Ye, Jiancheng AU - Woods, Donna AU - Bannon, Jennifer AU - Bilaver, Lucy AU - Kricke, Gayle AU - McHugh, Megan AU - Kho, Abel AU - Walunas, Theresa PY - 2022 DA - 2022/6/24 TI -利用信息学驱动模型识别初级保健质量改进实践促进的环境因素和策略:框架开发和混合方法的案例研究乔- JMIR哼因素SP - e32174六世- 9 - 2 KW -质量改进KW -实践便利KW -初级保健KW -混合方法KW -练习主持人KW -信息学KW -电子健康记录KW -实现科学KW——实现千瓦-挑战千瓦策略KW -框架KW -角度AB -背景:过去十年中已遇到越来越多的机遇和努力将质量改进集成到卫生保健。实践促进是一种经过验证的策略，用于支持初级保健实践的重新设计和改进，重点是建立持续改进的组织能力。实践领导、工作人员和实践促进者都在支持初级保健的质量改进方面发挥着重要作用。然而，他们对影响质量改进计划的背景、促成因素、障碍和策略的看法却知之甚少。目的:本研究旨在开发一个框架，以评估影响实践促进、临床测量绩效和质量改进干预措施实施的环境因素、挑战和策略。我们还通过一个实际案例研究说明了该框架的应用。方法:我们开发了TITO(任务、个人、技术和组织)框架，通过举办参与性利益相关者研讨会，并结合他们的观点来确定质量改进和实践促进的促成因素和障碍。我们进行了一个案例研究，使用混合方法方法来演示框架的使用，并描述参与心脏地带健康研究的初级保健实践的实践促进和影响质量改进的因素。结果:所提出的框架被用于组织和分析基于框架域的不同利益相关者的观点和关键因素。 The case study showed that practice leaders, staff, and practice facilitators all influenced the success of the quality improvement program. However, these participants faced different challenges and used different strategies. The framework showed that barriers stemmed from patients’ social determinants of health, a lack of staff and time, and unsystematic facilitation resources, while enablers included practice culture, staff buy-in, implementation of effective practice facilitation strategies, practice capacity for change, and shared complementary resources from similar, ongoing programs. Conclusions: Our framework provided a useful and generalizable structure to guide and support assessment of future practice facilitation projects, quality improvement initiatives, and health care intervention implementation studies. The practice leader, staff, and practice facilitator all saw value in the quality improvement program and practice facilitation. Practice facilitators are key liaisons to help the quality improvement program; they help all stakeholders work toward a shared target and leverage tailored strategies. Taking advantage of resources from competing, yet complementary, programs as additional support may accelerate the effective achievement of quality improvement goals. Practice facilitation–supported quality improvement programs may be opportunities to assist primary care practices in achieving improved quality of care through focused and targeted efforts. The case study demonstrated how our framework can support a better understanding of contextual factors for practice facilitation, which could enable well-prepared and more successful quality improvement programs for primary care practices. Combining implementation science and informatics thinking, our TITO framework may facilitate interdisciplinary research in both fields. SN - 2292-9495 UR - https://humanfactors.www.mybigtv.com/2022/2/e32174 UR - https://doi.org/10.2196/32174 UR - http://www.ncbi.nlm.nih.gov/pubmed/35749211 DO - 10.2196/32174 ID - info:doi/10.2196/32174 ER -