背景:医院通常会收集大量的行政数据,例如住院时间,28天再入院,和医院获得性并发症;然而,这些数据未被用于持续专业发展(CPD)。首先,这些临床指标很少在现有的质量和安全性报告之外进行审查.第二,许多医学专家认为他们的CPD要求很耗时,对实践变化和改善患者预后的影响最小。有机会根据这些数据构建新的用户界面,旨在支持个人和群体反思。数据知情的反思性实践有可能产生关于绩效的新见解,弥合CPD与临床实践之间的差距。
目的:本研究旨在了解为什么常规收集的管理数据尚未广泛用于支持反思性实践和终身学习。
方法:我们对来自不同背景的思想领袖进行了半结构化访谈(N=19),包括临床医生,外科医生,首席医疗官,信息和通信技术专业人员,信息学家,研究人员,以及相关行业的领导者。访谈由2名独立编码人员进行主题分析。
结果:受访者确定了结果的可见性,同行比较,小组反思讨论,和实践变化作为潜在的好处。主要障碍包括传统技术,对数据质量的不信任,隐私,数据误解,团队文化。受访者建议招募当地冠军进行联合设计,呈现用于理解的数据而不是信息,由专业小组组长指导,并及时反思与CPD相关,作为成功实施的推动力。
结论:总体而言,思想领袖之间达成了共识,汇集来自不同背景和医疗管辖区的见解。我们发现,尽管对基础数据质量存在担忧,但临床医生仍有兴趣将行政数据重新用于专业发展。隐私,传统技术,和视觉演示。他们更喜欢由支持性专业小组组长领导的小组反思,而不是个人的反思。我们的发现提供了对具体益处的新颖见解,障碍,以及基于这些数据集的潜在反思性实践界面的好处。他们可以为设计与年度CPD计划-记录-反射周期相关的院内反射新模型提供信息。
Hospitals routinely collect large amounts of administrative data such as length of stay, 28-day readmissions, and hospital-acquired complications; yet, these data are underused for continuing professional development (CPD). First, these clinical indicators are rarely reviewed outside of existing quality and safety reporting. Second, many medical specialists view their CPD requirements as time-consuming, having minimal impact on practice change and improving patient outcomes. There is an opportunity to build new user interfaces based on these data, designed to support individual and group reflection. Data-informed reflective practice has the potential to generate new insights about performance, bridging the gap between CPD and clinical practice.
This
study aims to understand why routinely collected administrative data have not yet become widely used to support reflective practice and lifelong learning.
We conducted semistructured interviews (N=19) with thought leaders from a range of backgrounds, including clinicians, surgeons, chief medical officers, information and communications technology professionals, informaticians, researchers, and leaders from related industries. Interviews were thematically analyzed by 2 independent coders.
Respondents identified visibility of outcomes, peer comparison, group reflective discussions, and practice change as potential benefits. The key barriers included legacy technology, distrust with data quality, privacy, data misinterpretation, and team culture. Respondents suggested recruiting local champions for co-design, presenting data for understanding rather than information, coaching by specialty group leaders, and timely reflection linked to CPD as enablers to successful implementation.
Overall, there was consensus among thought leaders, bringing together insights from diverse backgrounds and medical jurisdictions. We found that clinicians are interested in repurposing administrative data for professional development despite concerns with underlying data quality, privacy, legacy technology, and visual presentation. They prefer group reflection led by supportive specialty group leaders, rather than individual reflection. Our findings provide novel insights into the specific benefits, barriers, and benefits of potential reflective practice interfaces based on these data sets. They can inform the design of new models of in-hospital reflection linked to the annual CPD planning-recording-reflection cycle.