PDF(Pubmed)
Abstract：
BACKGROUND: Quality improvement (QI) programs based on person-centred outcome measures (PCOMs) play an important role in promoting optimal palliative care. However, routine use of PCOMs has been slow and difficult to implement, including within QI programs.
OBJECTIVE: This study aimed to identify implementation strategies that support the implementation of PCOMs as routine practice in hospital-based palliative care, as well as the implementation theories, models and frameworks (TMFs) guiding the design of these implementation strategies.
METHODS: A scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) Scoping Review framework. Four databases (Medline, CINAHL, Scopus and PubMed) were systematically searched for literature published between 1 January 1990 and 8 March 2024.
RESULTS: One hundred and fifteen unique implementation strategies, identified from 11 included studies, were mapped onto the 73 Expert Recommendations for Implementing Change (ERIC) discrete implementation strategies, covering 52% of the ERIC strategies. The most commonly used categories were train and educate stakeholders, and support clinicians, followed by develop stakeholder interrelationships and use evaluation and iterative strategies. Three key themes emerged: what to do; how to do it; and who to do it with. Only four studies employed TMFs to guide the design of the implementation strategies in this review.
CONCLUSIONS: To promote the implementation of PCOM-based QI programs, strategies should be developed based on identified/potential barriers and facilitators by using rigorous TMFs. The components of the implementation strategies must be reported transparently and consistently to enable replication and measurement in future research and practice.
UNASSIGNED: This scoping review does not directly involve patients or the general public in its design or execution. However, it is part of an implementation study aimed at integrating the Palliative Care Outcome Collaboration (PCOC) model into routine clinical practice at a cancer hospital in China. Before the formal implementation, palliative care professionals from this hospital highlighted the need for a comprehensive analysis of existing evidence to support the effective adoption of the PCOC model in their specific clinical setting.
OBJECTIVE: This study aimed to identify implementation strategies that support the implementation of PCOMs as routine practice in hospital-based palliative care, as well as the implementation theories, models and frameworks (TMFs) guiding the design of these implementation strategies.
METHODS: A scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) Scoping Review framework. Four databases (Medline, CINAHL, Scopus and PubMed) were systematically searched for literature published between 1 January 1990 and 8 March 2024.
RESULTS: One hundred and fifteen unique implementation strategies, identified from 11 included studies, were mapped onto the 73 Expert Recommendations for Implementing Change (ERIC) discrete implementation strategies, covering 52% of the ERIC strategies. The most commonly used categories were train and educate stakeholders, and support clinicians, followed by develop stakeholder interrelationships and use evaluation and iterative strategies. Three key themes emerged: what to do; how to do it; and who to do it with. Only four studies employed TMFs to guide the design of the implementation strategies in this review.
CONCLUSIONS: To promote the implementation of PCOM-based QI programs, strategies should be developed based on identified/potential barriers and facilitators by using rigorous TMFs. The components of the implementation strategies must be reported transparently and consistently to enable replication and measurement in future research and practice.
UNASSIGNED: This scoping review does not directly involve patients or the general public in its design or execution. However, it is part of an implementation study aimed at integrating the Palliative Care Outcome Collaboration (PCOC) model into routine clinical practice at a cancer hospital in China. Before the formal implementation, palliative care professionals from this hospital highlighted the need for a comprehensive analysis of existing evidence to support the effective adoption of the PCOC model in their specific clinical setting.
摘要：
背景：基于以人为中心的结果测量（PCOM）的质量改善（QI）计划在促进最佳姑息治疗方面发挥着重要作用。然而,PCOM的常规使用缓慢且难以实现，包括在QI计划中。
目的：本研究旨在确定支持将PCOM作为医院姑息治疗常规实践的实施策略，以及实施理论，指导这些实施策略设计的模型和框架(TMF)。
方法：根据JoannaBriggsInstitute（JBI）范围审查框架进行了范围审查。四个数据库(Medline，CINAHL,对Scopus和PubMed）进行了系统搜索，以查找1990年1月1日至2024年3月8日之间发表的文献。
结果：115个独特的实施策略，从11项纳入的研究中确定，被映射到73项实施变更的专家建议(ERIC)离散实施策略上，涵盖52%的ERIC战略。最常用的类别是培训和教育利益相关者，并支持临床医生，然后发展利益相关者的相互关系，并使用评估和迭代策略。出现了三个关键主题：做什么；如何做；以及与谁一起做。在本次审查中，只有四项研究采用了TMF来指导实施策略的设计。
结论：为了促进基于PCOM的QI计划的实施，应通过使用严格的TMF，根据已识别/潜在的障碍和促进因素制定策略。必须透明和一致地报告实施战略的组成部分，以便在未来的研究和实践中进行复制和衡量。
■此范围审查在其设计或执行中不直接涉及患者或公众。然而,这是一项实施研究的一部分,旨在将姑息治疗结果合作(PCOC)模式纳入中国一家癌症医院的常规临床实践.在正式实施之前，该医院的姑息治疗专业人员强调，需要对现有证据进行全面分析，以支持在其特定临床环境中有效采用PCOC模型。
目的：本研究旨在确定支持将PCOM作为医院姑息治疗常规实践的实施策略，以及实施理论，指导这些实施策略设计的模型和框架(TMF)。
方法：根据JoannaBriggsInstitute（JBI）范围审查框架进行了范围审查。四个数据库(Medline，CINAHL,对Scopus和PubMed）进行了系统搜索，以查找1990年1月1日至2024年3月8日之间发表的文献。
结果：115个独特的实施策略，从11项纳入的研究中确定，被映射到73项实施变更的专家建议(ERIC)离散实施策略上，涵盖52%的ERIC战略。最常用的类别是培训和教育利益相关者，并支持临床医生，然后发展利益相关者的相互关系，并使用评估和迭代策略。出现了三个关键主题：做什么；如何做；以及与谁一起做。在本次审查中，只有四项研究采用了TMF来指导实施策略的设计。
结论：为了促进基于PCOM的QI计划的实施，应通过使用严格的TMF，根据已识别/潜在的障碍和促进因素制定策略。必须透明和一致地报告实施战略的组成部分，以便在未来的研究和实践中进行复制和衡量。
■此范围审查在其设计或执行中不直接涉及患者或公众。然而,这是一项实施研究的一部分,旨在将姑息治疗结果合作(PCOC)模式纳入中国一家癌症医院的常规临床实践.在正式实施之前，该医院的姑息治疗专业人员强调，需要对现有证据进行全面分析，以支持在其特定临床环境中有效采用PCOC模型。
