Ethnography

人种学
  • 文章类型: Journal Article
    与人类有关的定性研究,奶牛,来自不同学科的科学家在许多针对乳制品科学受众的期刊上发表了小牛和农业。我们的目的是调查除了从事乳制品科学工作的科学界如何描述,分析和讨论奶牛养殖,因为我们发现将这项研究引起乳品科学家的注意很重要。总的来说,117篇文章被确定为涉及一种或多种与奶牛有关的定性研究方法。审查提出了丰富的观点,与奶牛相关的新见解和讨论,农民,农业和部门,与社会问题、食物和生态景观有关。使用了广泛的定性研究方法,文献针对动物的问题,农场,社会,食物系统和景观水平。一些人提出了关于现有结构的关键问题,突出了行业的不公平,或者指向新的潜在未来和当代议程。我们希望研究人员回顾新的文献来源,并建议来自不同学科的研究人员之间进行更紧密的跨学科合作,以促进涉及奶牛的研究的未来发展。Further,参与这种互动可能是相关的,甚至是必要的,以避免围绕该部门未来发展的两极分化加剧,例如,与气候变化有关,或者工业化似乎如何推动不平等或忽视动物本身的代理。从不同角度探索养殖视角可以丰富未来乳业研究的成果。
    Qualitative research related to humans, dairy cows, calves and farming has been published by scientists from a variety of disciplines in many journals targeting dairy science audiences. We aimed to investigate how scientific communities other than those working in dairy science describe, analyze and discuss dairy farming, because we found it important to bring this research to the attention of dairy scientists. In total, 117 articles were identified as involving one or more qualitative research methods in relation to dairy cattle. The review brought out a wealth of perspectives, new insights and discussions related to dairy cattle, farmers, farming and the sector, and in relation to societal issues and food and ecological landscapes. A broad range of qualitative research methods were used, and the literature targeted issues at the animal, farm, societal, food system and landscape level. Some raised critical questions about existing structures, highlighted unfairness in the industry, or pointed to new potential futures and contemporary agendas. We expect that it will be inspirational and stimulating for researchers to review new sources of literature and suggest a closer interdisciplinary collaboration among researchers from different disciplines for the future development of research involving dairy cattle. Further, it could be relevant and even necessary to engage in such interaction to avoid increasing polarization around future development of the sector, for example related to climate change or how industrialization seems to push inequity or ignore the agency of animals themselves. Exploring perspectives of farming from different angles could enrich the outcomes of future dairy research.
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  • 文章类型: Systematic Review
    背景:这项研究的目标是确定现有的变化,为什么,作为实施科学项目的一部分,人类学实践由谁进行。作为受过博士学位训练的人类学家,我们试图描述“人种学”一词如何以及为什么在实施科学文献中被不同地应用,并描述了该领域内和整个领域的人类学实践。
    方法:虽然我们遵循PRISMA-ScR清单,我们以叙述方式呈现工作,以准确反映我们的审查过程。卫生服务图书馆员使用以下数据库的主题标题和关键字制定了搜索策略:PubMed,Embase(Elsevier),CochraneCENTRAL(Wiley),CIHAHL(EBSCO),PsycINFO(EBSCO),WebofScience核心合集,和人类学加(EBSCO)。我们专注于在医疗保健环境中进行的实施研究中的人类学实践,在英语中,没有日期限制。如果研究在研究设计方面应用人类学方法的一个或几个要素,数据收集,和/或分析。
    结果:删除重复项之后,数据库搜索产生了3450个结果,被添加到Rayyan进行两轮筛选的标题和摘要。全文筛选共纳入487篇文章。其中,227个被纳入并接受了我们记录的数据提取,并在三个主要领域进行了描述性统计分析:(1)人类学方法;(2)实施科学方法;(3)研究背景。我们发现,人种学和实地笔记等人类学特征工具的使用通常没有被系统地描述,而是经常被提及。Further,我们发现研究设计决策和妥协(例如,在现场的时间长度,利益相关者参与的物流,调和不同的第一手经验)通常会影响人类学方法,但没有系统地描述。
    结论:人类学工作通常支持更大的,混合方法实施项目,但没有彻底报告。语境对人类学实践至关重要,对实施研究也是隐含的基础,然而,人类学的目标以及其实践如何为大型研究项目提供信息通常没有明确说明。
    BACKGROUND: This study\'s goal is to identify the existing variation in how, why, and by whom anthropological practice is conducted as part of implementation science projects. As doctorally trained anthropologists, we sought to characterize how and why the term \"ethnography\" was variously applied in the implementation science literature and characterize the practice of anthropology within and across the field.
    METHODS: While we follow the PRISMA-ScR checklist, we present the work with a narrative approach to accurately reflect our review process. A health services librarian developed a search strategy using subject headings and keywords for the following databases: PubMed, Embase (Elsevier), Cochrane CENTRAL (Wiley), CIHAHL (EBSCO), PsycINFO (EBSCO), Web of Science Core Collection, and Anthropology Plus (EBSCO). We focused on the practice of anthropology in implementation research conducted in a healthcare setting, in English, with no date restrictions. Studies were included if they applied one or several elements of anthropological methods in terms of study design, data collection, and/or analysis.
    RESULTS: The database searches produced 3450 results combined after duplicates were removed, which were added to Rayyan for two rounds of screening by title and abstract. A total of 487 articles were included in the full-text screening. Of these, 227 were included and received data extraction that we recorded and analyzed with descriptive statistics in three main domains: (1) anthropological methods; (2) implementation science methods; and (3) study context. We found the use of characteristic tools of anthropology like ethnography and field notes are usually not systematically described but often mentioned. Further, we found that research design decisions and compromises (e.g., length of time in the field, logistics of stakeholder involvement, reconciling diverse firsthand experiences) that often impact anthropological approaches are not systematically described.
    CONCLUSIONS: Anthropological work often supports larger, mixed-methods implementation projects without being thoroughly reported. Context is essential to anthropological practice and implicitly fundamental to implementation research, yet the goals of anthropology and how its practice informs larger research projects are often not explicitly stated.
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  • 文章类型: Journal Article
    网络是一种特殊的定性社交媒体研究。它应用人种学技术来理解现代数字通信环境中的社交互动。本文旨在强调该研究领域的关键贡献者和知识结构。利用从Scopus数据库检索的722篇文章的书目数据,研究人员使用性能分析来洞察最多产的作者,机构,国家和期刊。关键词共现分析绘制知识结构图。专题地图工具用于识别基本主题,电机主题,利基主题,和新兴主题,以提出未来的研究方向。结果表明,在研究出版物方面,最有生产力的国家是英国。最赚钱的组织被公认为格里菲斯大学。最有影响力的作者是MkonoM。最足智多谋的来源是商业研究杂志。此外,由于关键词分析的同时出现,确定了三个对利用网络描记术研究很重要的重要知识集群,即消费者行为,在线品牌社区和真实性的共同创造。Further,利基和新兴主题包括可持续旅游,客户参与和共享经济。当作为一个整体,这篇综述是快速了解最新研究结果和进一步研究的潜在方向的有用工具。尚未对商业和管理研究中的网络状况进行系统的评估。因此,本研究旨在深入了解过去几十年来Netnography研究领域的最新状况以及未来的研究方向。研究该领域的最新技术增加了学术知识,并提供了有关该程序的最新信息。
    Netnography is a special kind of qualitative social media research. It applies ethnographic techniques to comprehend social interaction in settings of modern digital communications. This article aims to highlight the key contributors and knowledge structure of this research domain. Utilizing bibliographic data of 722 articles retrieved from the Scopus database, researchers used performance analysis to have insights into the most prolific authors, institutions, countries and journals. Keywords co-occurrence analysis was done to map the knowledge structure. The thematic map tool was used to recognize basic themes, motor themes, niche themes, and emerging themes in order to suggest future research directions. The results indicate that, in terms of research publications, the most productive nation is the United Kingdom. The most lucrative organization has been acknowledged as Griffith University. The most influential author is stated to be Mkono M. The most resourceful source is Journal of Business Research. In addition, three significant knowledge clusters important to study utilizing netnography were identified as a result of co-occurrence of keywords analysis namely, consumer behaviour, co-creation in online brand communities and authenticity. Further, niche and emerging themes include-sustainable tourism, customer engagement and sharing economy. When taken as a whole, this review is a useful tool for quickly understanding the most recent research findings and potential directions for further investigation. An assessment of the state of netnography in business and management research has not been systematically investigated. Hence, the present study aims to thorough a grasp of the state-of-the-art in Netnography research field over the past decades along with the future research directions. Studying the state of the art in the field adds to academic knowledge and provides updated information on the procedure.
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  • 文章类型: Journal Article
    近年来,定性研究在乳品科学中的使用已大大增加,为研究和实践提供信息的机会。这篇综述旨在提高一系列受众的定性研究的可及性,特别是:(1)概述定性研究是什么,以及它可以为乳制品环境中的科学调查带来的价值,(2)说明了过去15到20年间出现的定性乳品科学研究,(3)概述研究人员的角色和定性研究背后的关键哲学假设,(4)描述定性研究方法和在乳品科学研究中使用的方法,(5)强调用于确保研究可信度的定性调查的关键方面。乳制品科学中的定性方法使研究人员能够理解无数主题,包括利益相关者关系,决策,关于奶牛管理的行为,动物福利,和疾病预防控制措施。通常用于定性数据收集的方法是个人访谈和焦点小组,主题分析的变化是常见的分析框架。为了评估公共价值,态度,和感知,定期使用混合方法问卷,将定量数据与开放式问题的定性数据相结合。虽然仍然不经常使用,行动研究和参与式方法有可能通过促进基于小组的学习和农场变革来弥合研究实施差距。一些出版物描述了定性研究固有的哲学假设,许多作者包括反身性和位置性陈述。尽管在定性研究中对满足可信度标准的策略进行全面描述并不常见,许多出版物提到了可信度的某些方面,如成员检查,研究员三角测量,和反身笔记的记录。定性研究已被用来加深我们对乳制品行业相关现象的理解,并为广泛的新机会打开了大门。除了有自己的优点,定性研究可以指导,通知,并扩大定量研究,对定性研究核心支柱的理解可以促进跨学科合作。
    The use of qualitative research in dairy science has increased considerably in recent years, providing the opportunity to inform research and practice. This review aims to enhance the accessibility of qualitative research among a range of audiences and specifically: (1) provide an overview of what qualitative research is and the value it can bring to scientific inquiries in the dairy context, (2) illustrate the emergence of qualitative dairy science research in the past 15 to 20 years, (3) outline the role of the researcher and key philosophical assumptions underlying qualitative research, (4) describe qualitative research approaches and methods used in dairy science research, and (5) highlight key aspects of qualitative inquiry used to ensure research trustworthiness. Qualitative approaches in dairy science enable researchers to understand myriad topics including stakeholder relationships, decision-making, and behaviors regarding dairy cattle management, animal welfare, and disease prevention and control measures. Approaches that were used often for qualitative data collection were individual interviews and focus groups, and variations of thematic analysis were common analytical frameworks. To assess public values, attitudes, and perceptions, mixed methods questionnaires that combined quantitative data with qualitative data from open-ended questions were used regularly. Although still used infrequently, action research and participatory approaches have the potential to bridge the research-implementation gap by facilitating group-based learning and on-farm changes. Some publications described the philosophical assumptions inherent to qualitative research, and many authors included reflexivity and positionality statements. Although a comprehensive description of strategies to meet trustworthiness criteria for qualitative research was uncommon, many publications mentioned certain aspects of trustworthiness, such as member checking, researcher triangulation, and the recording of reflexive notes. Qualitative research has been used to deepen our understanding of phenomena relevant to the dairy sector and has opened the door for a broad array of new opportunities. In addition to having merit on its own, qualitative research can guide, inform, and expand on quantitative research, and an understanding of the core pillars of qualitative research can foster interdisciplinary collaborations.
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  • 文章类型: Journal Article
    对妊娠期疟疾(MiP)的定性研究是初期的,因此它的上下文,经验和符号相关因素是未知的。本研究将对MiP的定性研究系统化,描述知识,关于MiP的看法和行为,并编译个人,社会经济,通过10个数据库中的元合成,MiP的文化和卫生系统决定因素。共有48项研究纳入2600名孕妇,1300名医护人员,和2200名亲戚或社区成员。在ITN和病例管理方面展示了广泛的知识,但是在SP-IPTp上缺乏,MiP的风险和后果。对ANC和MiP预防持负面态度。信任得分高,对传统医学的偏爱和对药物安全性的不信任。卫生系统的主要决定因素是配给,共付额,延迟支付给诊所,高额的自付费用,短缺,劳动力少,工作过载,护理质量方面的缺点,医护人员对MiP的了解不足,对护理的消极态度。社会经济和文化决定因素是孕妇的贫困和低教育水平,距离医院,父权制-性别歧视的性别角色,以及当地对母婴健康的观念占主导地位。荟萃综合证明了检测MiP决定因素的困难以及在实施MiP策略以了解疾病的多维性之前进行定性研究的重要性。
    Qualitative research on malaria in pregnancy (MiP) is incipient, therefore its contextual, experiential and symbolic associated factors are unknown. This study systematizes the qualitative research on MiP, describes knowledge, perceptions and behaviors about MiP, and compiles individual, socioeconomic, cultural and health system determinants of MiP through a meta-synthesis in 10 databases. A total of 48 studies were included with 2600 pregnant women, 1300 healthcare workers, and 2200 relatives or community members. Extensive knowledge was demonstrated on ITN and case management, but it was lacking on SP-IPTp, risks and consequences of MiP. Attitudes were negative towards ANC and MiP prevention. There were high trustfulness scores and preference for traditional medicine and distrust in the safety of drugs. The main determinants of the Health System were rationing, copayments, delay in payment to clinics, high out-of-pocket expenses, shortage, low workforce and work overload, shortcomings in care quality, low knowledges of healthcare workers on MiP and negative attitude in care. The socioeconomic and cultural determinants were poverty and low educational level of pregnant women, distance to the hospital, patriarchal-sexist gender roles, and predominance of local conceptions on maternal-fetal-neonatal health. The meta-synthesis demonstrates the difficulty to detect MiP determinants and the importance of performed qualitative research before implementing MiP strategies to understand the multidimensionality of the disease.
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  • 文章类型: Journal Article
    在线人种学一直为慢性病患者做出独特的贡献,作为离线人种学的补充。它还可以用于研究互联网背景下慢性病患者的复杂性和偶然性。因此,有必要综合有关慢性病患者在线人种学研究活动的现有知识。
    这项范围审查旨在概述在线人种学在慢性病患者中应用的现有证据,着眼于特点,捐款,和实施过程。这将为将来使用在线人种学提供建议。
    我们遵循了Arksey和O\'Malley以及JoannaBriggs研究所开发的范围审查方法。在PubMed上进行了全面搜索,CINAHL,Embase,Scopus,和使用预选关键字的PsycInfo数据库。搜索仅限于2000年1月1日至2022年2月1日之间用英文撰写的文档。删除重复项后,文章由两名阅读标题的独立审稿人筛选,abstract,和全文。一位审阅者提取了数据,对其进行了描述性分析,以映射现有知识。
    经过2836个标题和摘要以及51个全文的筛选,分析中包括27种出版物,2009年至2022年出版。大多数研究来自美国(11/27,40.7%),大多数文章从在线论坛收集数据(10/27,37.0%)。此外,最常用的研究人员参与类型是被动分析(24/27,88.9%),18.5%(5/27)的主题与精神病患者有关。值得注意的是,大多数文章没有详细报道浸泡过程(17/25,63.0%)。88.9%(24/27)的文章中提到了伦理问题。
    我们分析了各个领域的当前文献,发现可以利用在线人种学来探索患有慢性病的人的更深层次的经验,这些慢性病很难使用传统的人种学进行调查。我们发现研究人员的参与是多种多样的,浸没过程,数据收集,和数据分析。然而,大多数研究报告了对在线环境的沉浸不足。研究人员应确定研究方法和数据资源,以便在研究之前完成文化沉浸。我们还发现,道德问题没有统一的标准。因此,我们建议研究人员收集公共和私人数据,获得知情同意,并保护患有慢性病的在线用户的隐私和机密性。研究结果可为在线医疗保健在慢性病研究中的应用提供实践参考。
    Online ethnography has been making a unique contribution to people with chronic conditions as a complement to offline ethnography. It can also be used to study the complexities and contingencies of people with chronic conditions in the context of the internet. Therefore, there is a need to synthesize existing knowledge on research activities concerning online ethnography for people with chronic conditions.
    This scoping review aimed to profile the existing evidence on the application of online ethnography for people with chronic conditions, focusing on the characteristics, contributions, and implementation process. This will provide recommendations for the future use of online ethnography.
    We followed the scoping review methodologies developed by Arksey and O\' Malley and the Joanna Briggs Institute. A comprehensive search was conducted on the PubMed, CINAHL, Embase, Scopus, and PsycInfo databases using preselected keywords. The search was limited to documents written in English and published between January 1, 2000, and February 1, 2022. After removal of duplicates, articles were screened by 2 independent reviewers reading the title, abstract, and full text. One reviewer extracted data, which were descriptively analyzed to map the existing knowledge.
    After 2836 titles and abstracts and 51 full texts were screened, 27 publications were included in the analysis, published between 2009 and 2022. Most studies were from the United States (11/27, 40.7%), and most articles collected data from online forums (10/27, 37.0%). Moreover, the most commonly used type of researcher involvement was passive analysis (24/27, 88.9%), and 18.5% (5/27) of the topics concerned people with mental illness. Notably, the majority of articles did not report the immersion process in detail (17/25, 63.0%). Ethical issues were mentioned in 88.9% (24/27) of the included articles.
    We analyzed the current literature across fields and found that online ethnography can be exploited to explore the deeper experience of people with chronic conditions that are difficult to investigate using traditional ethnography. We found that there was diversity in researcher involvement, immersion process, data collection, and data analysis. However, most studies reported the insufficient immersion into the online environment. Researchers should determine the research approaches and data resources in order to complete culture immersion before researching. We also found that there was no uniform standard for ethical issues. Therefore, we recommend that researchers collect public and private data, obtain informed consent, and preserve the privacy and confidentiality of online users with chronic conditions. The findings can provide a practical reference for the use of online health care in studying chronic conditions.
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  • 文章类型: Journal Article
    额颞叶痴呆(FTD)的特征在于额叶和/或颞叶的萎缩。患有FTD的人从一开始就表现出语言和情绪障碍,沟通问题通常会影响FTD患者及其家人,甚至在诊断之前。FTD的这些独特特征尚未得到很好的理解,并为与FTD一起生活的人们及其家人带来了实质性问题。这篇评论探讨了FTD患者家庭的经历。根据系统评价和荟萃分析指南的首选报告项目选择和筛选研究。我们搜索了四个书目数据库,以获取截至2021年2月的文章,以确定有关家庭经历的定性数据。定性研究的关键评估技能计划清单用于评估所有纳入的研究。在235篇文章中,我们在定性综合中纳入了六项研究。进行了元人种学来解释FTD患者的家庭经历。新出现的概念被合成为五个主题:我所爱的人出了问题;没有人完全理解;用FTD照顾所爱的人的存在的痛苦;由于特定的FTD症状而增加的负担;并被迫适应与FTD所爱的人一起生活的新的和独特的方式。这篇综述强调了家庭的困惑和痛苦(这始于疾病的早期阶段,有时在诊断之前)以及与FTD患者沟通的困难。这些发现对未来的实践有启示,因为他们证明了早期提供的适当支持对家庭生活的积极影响,而不是在疾病进展后。
    Frontotemporal dementia (FTD) is characterised by atrophy of the frontal and/or temporal lobes. People with FTD show language and emotional disturbances from onset, and communication problems usually affect people with FTD and their families even before diagnosis. These unique characteristics of FTD are not well understood and create substantial problems for people living with FTD and their families. This review explores the experiences of families of people living with FTD. Studies were selected and screened according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched four bibliographic databases for articles up to February 2021 to identify qualitative data on the experiences of families. The Critical Appraisal Skills Programme checklist for qualitative studies was used to assess all included studies. Of 235 identified articles, we included six studies in the qualitative synthesis. Meta-ethnography was conducted to interpret families\' experiences of people living with FTD. The emergent concepts were synthesised into five themes: Something is wrong with my loved one; No one fully understands; Existential pain of caring for a loved one with FTD; Increased burden owing to specific FTD symptoms; and Forced to adapt to new and unique ways of living with a loved one with FTD. This review highlighted families\' confusion and suffering (which began in the early stages of the disease, and sometimes before diagnosis) and the difficulty of communicating with people with FTD. These findings have implications for future practice, as they demonstrate the positive effect on family life of appropriate support that is provided early, rather than after the disease has progressed.
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  • 文章类型: Journal Article
    BACKGROUND: The relationship between ethnography and healthcare improvement has been the subject of methodological concern. We conducted a scoping review of ethnographic literature on healthcare improvement topics, with two aims: (1) to describe current ethnographic methods and practices in healthcare improvement research and (2) to consider how these may affect habit and skill formation in the service of healthcare improvement.
    METHODS: We used a scoping review methodology drawing on Arksey and O\'Malley\'s methods and more recent guidance. We systematically searched electronic databases including Medline, PsychINFO, EMBASE and CINAHL for papers published between April 2013 - April 2018, with an update in September 2019. Information about study aims, methodology and recommendations for improvement were extracted. We used a theoretical framework outlining the habits and skills required for healthcare improvement to consider how ethnographic research may foster improvement skills.
    RESULTS: We included 283 studies covering a wide range of healthcare topics and methods. Ethnography was commonly used for healthcare improvement research about vulnerable populations, e.g. elderly, psychiatry. Focussed ethnography was a prominent method, using a rapid feedback loop into improvement through focus and insider status. Ethnographic approaches such as the use of theory and focus on every day practices can foster improvement skills and habits such as creativity, learning and systems thinking.
    CONCLUSIONS: We have identified that a variety of ethnographic approaches can be relevant to improvement. The skills and habits we identified may help ethnographers reflect on their approaches in planning healthcare improvement studies and guide peer-review in this field. An important area of future research will be to understand how ethnographic findings are received by decision-makers.
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  • 文章类型: Journal Article
    Ethnographies of health systems are a theoretically rich and rapidly growing area within medical anthropology. Critical ethnographic work dating back to the 1950s has taken policymakers and health staff as points of entry into the power structures that run through the global health enterprise. In the last decade, there has been a surge of ethnographic work on health systems. We conceptualize the anthropology of health systems as a field; review the history of this body of knowledge; and outline emergent literatures on policymaking, HIV, hospitals, Community Health Workers, health markets, pharmaceuticals, and metrics. High-quality ethnographic work is an excellent way to understand the complex systems that shape health outcomes, and provides a critical vantage point for thinking about global health policy and systems. As theory in this space develops and deepens, we argue that anthropologists should look beyond the discipline to think through what their work does and why it matters.
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  • 文章类型: Review
    背景:器械供过于求会增加手术室(OR)的成本。我们回顾了先前报道的减少手术器械的方法,并报道了通过人种学仪器跟踪拇指腕掌(CMC)关节置换术来优化器械供应的试点方法。此外,我们报告了仪器供过于求的成本分析和托盘优化方法的潜在节省。
    方法:在一家大型学术医院的门诊手术中心,由2名外科医生进行了8次CMC关节置换术,追踪了仪器的使用情况。设计了一种优化的供应方法。使用特定于卫生系统的数据和先前发表的研究进行了成本分析。
    结果:在8种CMC关节置换术中使用跟踪仪器后,在至少1例病例中,在Hand&Foot(H&F)托盘中的120种仪器中累计使用59种。在所有情况下都使用了两种仪器,在至少50%的病例中使用了另外20种仪器。使用带有59个乐器的缩小托盘,在没有剥离包装的情况下,减少60箱托盘的潜在成本节省估计为2086美元,剥离包装为2356美元。估计的成本节省低于文献报道的成本,这是由于分析中范围缩小和排除了OR时间成本。
    结论:仪器供过于求会导致我们机构门诊手术中心的成本上涨。人种学是一种具有成本效益的方法,可以跟踪仪器利用率并确定小型服务的最佳托盘组成,但无法扩展到大型卫生系统。观察足够的手术以减少供应所需的时间和成本,以激发对更有效的方法来确定仪器效用的需求。
    Instrument oversupply drives cost in the operating room (OR). We review previously reported methodologies for surgical instrument reduction and report a pilot methodology for optimizing instrument supply via ethnographic instrument tracking of thumb carpometacarpal (CMC) arthroplasties. Additionally, we report a cost analysis of instrument oversupply and potential savings of tray optimization methods.
    Instrument utilization was tracked over 8 CMC arthroplasties conducted by 2 surgeons at an ambulatory surgery center of a large academic hospital. An optimized supply methodology was designed. A cost analysis was conducted using health-system-specific data and previously published research.
    After tracking instrument use in 8 CMC arthroplasties, a cumulative total of 59 out of the 120 instruments in the Hand & Foot (H&F) tray were used in at least 1 case. Two instruments were used in all cases, and another 20 instruments were used in at least 50% of the cases. Using a reduced tray with 59 instruments, potential cost savings for tray reduction in 60 cases were estimated to be $2086 without peel-packing and $2356 with peel-packing. The estimated cost savings were lower than those reported in literature due to a reduced scope and exclusion of OR time cost in the analysis.
    Instrument oversupply drives cost at our institution\'s ambulatory surgery center. Ethnography is a cost-effective method to track instrument utilization and determine optimal tray composition for small services but is not scalable to large health systems. The time and cost required to observe sufficient surgeries to enable supply reduction to motivate the need for more efficient methods to determine instrument utility.
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