PDF(Pubmed)
Abstract：
BACKGROUND: Health organizations face the critical task of executing and overseeing comprehensive health care. To address the challenges associated with this task, evidence-based dashboards have emerged as valuable tools. Since 2016, the regional health organizations of Quebec, Canada, have been responsible for ensuring implementation of the Quebec Alzheimer Plan (QAP), a provincial plan that aims to reinforce the capacity of primary care services to detect, diagnose, and treat persons with dementia. Despite the provincial scope of the QAP, the diverse material and human resources across regions introduce variability in the interest, utility, and specific needs associated with these dashboards.
OBJECTIVE: The aim of this study was to assess the interest and utility of dashboards to support the QAP implementation, as well as to determine the needs for improving these aspects according to the perspectives of various types of professionals involved across regions.
METHODS: An evaluative study using qualitative methods was conducted within a collaborative research approach involving different stakeholders, including the ministerial advisor and the four project managers responsible for supporting the implementation of the QAP, as well as researchers/scientific advisors. To support these organizations, we developed tailored, 2-page paper dashboards, detailing quantitative data on the prevalence of dementia, the use of health services by persons with dementia, and achievements and challenges of the QAP implementation in each organization\'s jurisdiction. We then conducted 23 focus groups with the managers and leading clinicians involved in the implementation of the QAP of each regional health organization. Real-time notes were taken using a structured observation grid. Content analysis was conducted according to different regions (organizations with university mandates or nearby organizations, labeled \"university/peripheral\"; organizations for which only part of the territory is in rural areas, labeled \"mixed\"; and organizations in remote or isolated areas, labeled \"remote/isolated\") and according to different types of participants (managers, leading clinicians, and other participants).
RESULTS: Participants from organizations in all regions expressed interest in these dashboards and found them useful in several ways. However, they highlighted the need for indicators on orphan patients and other health care providers. Differences between regions were observed, particularly in the interest in continuity of care in university/peripheral regions and the need for diagnostic tools adapted to the culture in remote/isolated regions.
CONCLUSIONS: These dashboards support the implementation of an Alzheimer Plan and contribute to the emergence of a learning health care system culture. This project allows each region to increase its monitoring capacity for the implementation of the QAP and facilitates reflection among individuals locally carrying out the implementation. The perspectives expressed will guide the preparation of the next iteration of the dashboards.
OBJECTIVE: The aim of this study was to assess the interest and utility of dashboards to support the QAP implementation, as well as to determine the needs for improving these aspects according to the perspectives of various types of professionals involved across regions.
METHODS: An evaluative study using qualitative methods was conducted within a collaborative research approach involving different stakeholders, including the ministerial advisor and the four project managers responsible for supporting the implementation of the QAP, as well as researchers/scientific advisors. To support these organizations, we developed tailored, 2-page paper dashboards, detailing quantitative data on the prevalence of dementia, the use of health services by persons with dementia, and achievements and challenges of the QAP implementation in each organization\'s jurisdiction. We then conducted 23 focus groups with the managers and leading clinicians involved in the implementation of the QAP of each regional health organization. Real-time notes were taken using a structured observation grid. Content analysis was conducted according to different regions (organizations with university mandates or nearby organizations, labeled \"university/peripheral\"; organizations for which only part of the territory is in rural areas, labeled \"mixed\"; and organizations in remote or isolated areas, labeled \"remote/isolated\") and according to different types of participants (managers, leading clinicians, and other participants).
RESULTS: Participants from organizations in all regions expressed interest in these dashboards and found them useful in several ways. However, they highlighted the need for indicators on orphan patients and other health care providers. Differences between regions were observed, particularly in the interest in continuity of care in university/peripheral regions and the need for diagnostic tools adapted to the culture in remote/isolated regions.
CONCLUSIONS: These dashboards support the implementation of an Alzheimer Plan and contribute to the emergence of a learning health care system culture. This project allows each region to increase its monitoring capacity for the implementation of the QAP and facilitates reflection among individuals locally carrying out the implementation. The perspectives expressed will guide the preparation of the next iteration of the dashboards.
摘要：
背景：卫生机构面临执行和监督全面医疗保健的关键任务。要解决与此任务相关的挑战，基于证据的仪表板已经成为有价值的工具。自2016年以来，魁北克的区域卫生组织，加拿大,一直负责确保魁北克阿尔茨海默氏症计划（QAP）的实施，一项旨在加强初级保健服务检测能力的省级计划，诊断,治疗痴呆症患者。尽管QAP的范围是省级的，不同地区的不同物质和人力资源带来了兴趣的可变性，实用程序，以及与这些仪表板相关的特定需求。
目的：本研究的目的是评估支持QAP实施的仪表板的兴趣和效用，以及根据各地区涉及的各种类型的专业人员的观点来确定改进这些方面的需求。
方法：在涉及不同利益相关者的合作研究方法中，使用定性方法进行了评估研究。包括部长级顾问和负责支持QAP实施的四名项目经理，以及研究人员/科学顾问。为了支持这些组织，我们开发了量身定制的，2页纸仪表板，详细说明痴呆症患病率的定量数据，痴呆症患者使用卫生服务，以及QAP在每个组织管辖范围内实施的成就和挑战。然后，我们与参与每个区域卫生组织QAP实施的管理人员和主要临床医生进行了23个焦点小组。使用结构化的观察网格进行实时笔记。根据不同地区（有大学授权的组织或附近的组织，标记为“大学/外围设备”；只有部分领土在农村地区的组织，标记为“混合”；以及偏远地区或偏远地区的组织，标记为“远程/隔离”)，并根据不同类型的参与者(经理，领先的临床医生，和其他参与者)。
结果：来自所有地区组织的参与者都对这些仪表板表示了兴趣，并发现它们在几个方面很有用。然而,他们强调需要孤儿患者和其他医疗保健提供者的指标。观察到地区之间的差异，特别是对大学/周边地区护理连续性的兴趣，以及对适应偏远/偏远地区文化的诊断工具的需求。
结论：这些仪表板支持阿尔茨海默氏症计划的实施，并有助于学习型医疗保健系统文化的出现。该项目使每个区域都能够提高其对QAP实施的监测能力，并促进在当地实施的个人之间的反思。所表达的观点将指导仪表板下一次迭代的准备。
目的：本研究的目的是评估支持QAP实施的仪表板的兴趣和效用，以及根据各地区涉及的各种类型的专业人员的观点来确定改进这些方面的需求。
方法：在涉及不同利益相关者的合作研究方法中，使用定性方法进行了评估研究。包括部长级顾问和负责支持QAP实施的四名项目经理，以及研究人员/科学顾问。为了支持这些组织，我们开发了量身定制的，2页纸仪表板，详细说明痴呆症患病率的定量数据，痴呆症患者使用卫生服务，以及QAP在每个组织管辖范围内实施的成就和挑战。然后，我们与参与每个区域卫生组织QAP实施的管理人员和主要临床医生进行了23个焦点小组。使用结构化的观察网格进行实时笔记。根据不同地区（有大学授权的组织或附近的组织，标记为“大学/外围设备”；只有部分领土在农村地区的组织，标记为“混合”；以及偏远地区或偏远地区的组织，标记为“远程/隔离”)，并根据不同类型的参与者(经理，领先的临床医生，和其他参与者)。
结果：来自所有地区组织的参与者都对这些仪表板表示了兴趣，并发现它们在几个方面很有用。然而,他们强调需要孤儿患者和其他医疗保健提供者的指标。观察到地区之间的差异，特别是对大学/周边地区护理连续性的兴趣，以及对适应偏远/偏远地区文化的诊断工具的需求。
结论：这些仪表板支持阿尔茨海默氏症计划的实施，并有助于学习型医疗保健系统文化的出现。该项目使每个区域都能够提高其对QAP实施的监测能力，并促进在当地实施的个人之间的反思。所表达的观点将指导仪表板下一次迭代的准备。
