Exploring barriers and facilitators for implementation of novel image-guided minimally invasive procedures: nationwide experiences on navigation bronchoscopy.

IF 3.4 3区 医学 Q1 RESPIRATORY SYSTEM
Ferhat Beyaz, Renée M Geraats, Roel L J Verhoeven, Erik H F M van der Heijden, Rosella P M G Hermens, Julie E M Swillens
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引用次数: 0

Abstract

Background: Early-stage lung cancer mostly occurs asymptomatically and is found incidentally as peripheral pulmonary nodules on medical imaging. Cone beam CT-guided navigation bronchoscopy (CBCT-NB) is a novel and evidence-based minimally invasive procedure to obtain a tissue diagnosis from these pulmonary nodules. To clinically implement this innovation in practice, this study investigated barriers and facilitators to CBCT-NB implementation in a nationwide setting as observed in the Netherlands.

Methods: In-depth semistructured interviews and focus groups were conducted among healthcare professionals directly involved in the CBCT-NB implementation in hospitals nationwide. The updated Consolidated Framework for Implementation Research (CFIR) was used for creating the interview guide and structuring the analysis.

Results: 13 healthcare professionals spearheading implementation efforts across eight hospitals (three university, five non-university hospitals) were interviewed. A total of 52 facilitators and 38 barriers were identified throughout all CFIR domains. Important facilitators to CBCT-NB implementation were patient safety, reimbursement availability, future demand, intrinsic motivation of local implementation leaders and regional network collaborations and coordination on implementation. Main barriers included financial constraints, uncertainty about the availability of important resources, the need for new and complex skills acquisition and the anticipated time needed for the entire implementation process.

Conclusion: CBCT-NB is described as a highly valuable innovation within the field of diagnostic procedures for pulmonary nodules. Our findings reveal important barriers and facilitators to CBCT-NB implementation. Understanding these factors is crucial for developing and optimising implementation strategies to achieve successful implementation of innovative minimally invasive image-guided procedures like CBCT-NB in a nationwide setting.

Abstract Image

Abstract Image

探索新型图像引导微创手术实施的障碍和促进因素:导航支气管镜的全国经验。
背景:早期肺癌多无症状发生,在医学影像学上偶然发现为肺周围结节。锥形束ct引导下的导航支气管镜检查(CBCT-NB)是一种基于证据的新型微创手术,可从这些肺结节中获得组织诊断。为了在临床实践中实施这一创新,本研究调查了在荷兰全国范围内实施CBCT-NB的障碍和促进因素。方法:对全国医院直接参与CBCT-NB实施的医护人员进行深度半结构化访谈和焦点小组调查。更新后的实施研究综合框架(CFIR)用于创建访谈指南和构建分析。结果:13名医疗保健专业人员在八家医院(三所大学,五所非大学医院)率先实施工作进行了采访。在所有CFIR领域中,共确定了52个促进因素和38个障碍。促进CBCT-NB实施的重要因素是患者安全、可报销性、未来需求、当地实施领导者的内在动机以及区域网络在实施方面的合作与协调。主要障碍包括财政限制、能否获得重要资源的不确定性、需要掌握新的复杂技能以及整个执行过程所需的预期时间。结论:CBCT-NB被认为是肺结节诊断程序领域的一项极具价值的创新。我们的研究结果揭示了实施CBCT-NB的重要障碍和促进因素。了解这些因素对于制定和优化实施策略至关重要,从而在全国范围内成功实施创新的微创图像引导手术,如CBCT-NB。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMJ Open Respiratory Research
BMJ Open Respiratory Research RESPIRATORY SYSTEM-
CiteScore
6.60
自引率
2.40%
发文量
95
审稿时长
12 weeks
期刊介绍: BMJ Open Respiratory Research is a peer-reviewed, open access journal publishing respiratory and critical care medicine. It is the sister journal to Thorax and co-owned by the British Thoracic Society and BMJ. The journal focuses on robustness of methodology and scientific rigour with less emphasis on novelty or perceived impact. BMJ Open Respiratory Research operates a rapid review process, with continuous publication online, ensuring timely, up-to-date research is available worldwide. The journal publishes review articles and all research study types: Basic science including laboratory based experiments and animal models, Pilot studies or proof of concept, Observational studies, Study protocols, Registries, Clinical trials from phase I to multicentre randomised clinical trials, Systematic reviews and meta-analyses.
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