PDF(Pubmed)
Abstract：
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.
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是很重要的。基于网站的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。这篇综述研究了基于网站的工具如何为医疗保健专业人员提供质量改进，包括用于开发工具的最佳过程和有效工具的要素。
方法：对7个数据库进行了系统搜索，包括2012年1月至2024年1月发表的文章。如果文章经过同行评审，则包括在内，用英语写的,基于健康环境，并报告了为专业人员开发或评估基于网站的质量改进工具。使用NVivo进行叙述性合成。使用混合方法评估工具评估偏倚风险。所有论文均由两位作者使用Braun和Clarke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。确定的主题是工具开发过程，质量改进机制和障碍，以及工具使用的促进者。数字化现有质量改进流程(n=7)，确定实践中的差距(n=6)，促进专业发展(n=3)是共同的质量改进目标。工具与报告的临床任务准确性和效率的提高有关，提高对指导方针的遵守程度，促进反思性实践，并为持续质量改进提供量身定制的反馈。共同的特点是教育资源（n=7），并协助用户根据标准/建议评估当前的做法（n=6），支持专业人员实现更好的临床结果，在各种设置中提高了专业满意度和简化的工作流程。研究报告促进者使用工具，包括与实践的相关性，无障碍和促进多学科行动，使这些工具在医疗保健方面实用且省时。然而,诸如耗时等障碍，与实践无关，据报道，难以使用和缺乏组织参与。几乎所有工具都是与利益相关者共同开发的。共同设计的方法各不相同，反映不同程度的利益相关者参与和采用共同设计方法。值得注意的是，纳入研究的质量很低。
结论：这些发现为医疗保健领域基于网站的质量改进工具的未来发展提供了有价值的见解。建议包括确保与医疗保健专业人员共同开发工具，专注于实际可用性和解决常见障碍，以提高参与度和提高医疗质量的有效性。随机对照试验有必要提供工具疗效的客观证据。
背景：这项工作得到了预防研究支持计划的支持，由新南威尔士州卫生部资助，澳大利亚。
背景：此评论已在PROSPERO注册，不。CRD42023451346。
方法：对7个数据库进行了系统搜索，包括2012年1月至2024年1月发表的文章。如果文章经过同行评审，则包括在内，用英语写的,基于健康环境，并报告了为专业人员开发或评估基于网站的质量改进工具。使用NVivo进行叙述性合成。使用混合方法评估工具评估偏倚风险。所有论文均由两位作者使用Braun和Clarke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。确定的主题是工具开发过程，质量改进机制和障碍，以及工具使用的促进者。数字化现有质量改进流程(n=7)，确定实践中的差距(n=6)，促进专业发展(n=3)是共同的质量改进目标。工具与报告的临床任务准确性和效率的提高有关，提高对指导方针的遵守程度，促进反思性实践，并为持续质量改进提供量身定制的反馈。共同的特点是教育资源（n=7），并协助用户根据标准/建议评估当前的做法（n=6），支持专业人员实现更好的临床结果，在各种设置中提高了专业满意度和简化的工作流程。研究报告促进者使用工具，包括与实践的相关性，无障碍和促进多学科行动，使这些工具在医疗保健方面实用且省时。然而,诸如耗时等障碍，与实践无关，据报道，难以使用和缺乏组织参与。几乎所有工具都是与利益相关者共同开发的。共同设计的方法各不相同，反映不同程度的利益相关者参与和采用共同设计方法。值得注意的是，纳入研究的质量很低。
结论：这些发现为医疗保健领域基于网站的质量改进工具的未来发展提供了有价值的见解。建议包括确保与医疗保健专业人员共同开发工具，专注于实际可用性和解决常见障碍，以提高参与度和提高医疗质量的有效性。随机对照试验有必要提供工具疗效的客观证据。
背景：这项工作得到了预防研究支持计划的支持，由新南威尔士州卫生部资助，澳大利亚。
背景：此评论已在PROSPERO注册，不。CRD42023451346。
