开发家庭心脏基金会™旗帜、识别、网络、传递--家族性高胆固醇血症(FIND-FH™)实施工具包

IF 3.6 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Diane MacDougall MS, George Blike MD
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引用次数: 0

摘要

研究经费部分由 AMGEN 提供。背景/简介实施科学家指出,由于文化、专业知识和基础设施的差异,最佳实践往往无法推广到其他环境。在 18 个月的时间里,五个医疗保健系统和一个家族性高胆固醇血症患者团队参加了由家庭心脏基金会 (FHF) 领导的协作学习网络 (CLN),旨在改善家族性高胆固醇血症 (FH) 的诊断和护理。目标/目的分享 FIND-FH CLN 确定的最佳实践,帮助初级和专科护理诊所改善对 FH 患者的诊断和护理。为了实现这一目标,我们开发了一套灵活的实施工具包,供诊所根据其具体需求进行定制。方法我们采用一种新颖的实施科学方法来设计 FIND-FH 实施工具包,用有效的质量改进策略来武装医疗团队。该框架通过文献综述、主题专家、FH 患者以及五个参与 CLN 的现场经验,对常见问题/障碍和最佳实践进行了整理。通过多步骤流程,这些内容被组织成 "问题-一般解决方案-特定解决方案选项 "矩阵。CLN 参与者对矩阵提供反馈和改进意见,并由 FHF 的实施科学团队对矩阵进行整理。目前正在使用一种名义小组(专家共识)技术,以确保 "问题--一般解决方案 "对的完整性,并在随后使用多轮投票过程来评定每个问题--解决方案对的重要性。对评级存在差异的项目进行进一步讨论,并重复投票以达成共识。工具包中的具体解决方案选项描述了:a) 选项详情;b) 资源需求;以及 c) 优势/利弊。结果所述方法已用于 FIND-FH 流程的 "FLAG "和 "IDENTIFY "步骤。确定了有损初级保健医生和专科医生诊断 FH 患者的 17 个常见问题。针对每个问题确定了多达四个通用解决方案,每个通用解决方案又有多达六个具体解决方案可供选择。专家共识过程允许剔除被认为重要性/影响较低的问题。(见补充表 1)结论事实证明,开发一个实施工具包是可行的,该工具包提供了多种方案来解决影响家庭健康护理的常见问题。接下来,我们将完成 FIND-FH 流程中的 "网络 "和 "交付 "步骤,并对第一版工具包进行验证。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Development of the Family Heart Foundation™ Flag, Identify, Network, Deliver—Familial Hypercholesterolemia (FIND-FH™) Implementation Toolkit

Study Funding

Funded in part by AMGEN.

Background/Synopsis

Implementation scientists note that best practices often fail to generalize to other settings because of differences in culture, expertise, and infrastructure. Over 18 months, five healthcare systems and a team of patients with FH participated in a Family Heart Foundation (FHF) led collaborative learning network (CLN) with the aim to improve Familial Hypercholesterolemia (FH) diagnosis and care.

Objective/Purpose

To share best practices identified by the FIND-FH CLN to help primary and specialty care clinics improve diagnosis and care of patients with FH. To achieve this objective, we developed a flexible implementation toolkit for clinics to customize to meet their specific needs.

Methods

A novel implementation science approach is being used to design a FIND-FH Implementation Toolkit to arm care teams with effective quality improvement strategies. This framework organizes common problems/barriers and best practices identified via literature review, subject matter experts, patients with FH and field experiences at five participating CLN sites. This content is organized into a Problem(s)—General Solution(s)—Specific Solution Option(s) matrix using a multi-step process. CLN participants provide feedback and refinements to the matrix, which is curated by the FHF's implementation science team. A nominal group (expert consensus) technique is being used to assure the Problem—General Solution pairs are complete and a subsequent multi-voting process used to rate the importance of each problem-solution pair. Items with variation in ratings are discussed further and the voting repeated to arrive at consensus. The Specific Solution Option(s) in the toolkit describe: a) Option Details; b) Resource Needs; and c) Advantages/Tradeoffs.

Results

The methodology described has been completed for the “FLAG” and “IDENTIFY” steps of the FIND-FH process. 17 common Problems that undermine diagnosis of FH patients by PCPs and specialists, were identified. Up to four General Solutions were defined for each Problem with up to 6 Specific Solution Options for each General Solution. The expert consensus process allowed elimination of problems deemed low importance/impact. (See Supplemental Table 1)

Conclusions

Development of an implementation toolkit that provides multiple options to address common problems undermining FH care proved feasible. Next, we will complete the “NETWORK” and “DELIVER” steps of the FIND-FH process and validate the first version of this.

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来源期刊
CiteScore
7.00
自引率
6.80%
发文量
209
审稿时长
49 days
期刊介绍: Because the scope of clinical lipidology is broad, the topics addressed by the Journal are equally diverse. Typical articles explore lipidology as it is practiced in the treatment setting, recent developments in pharmacological research, reports of treatment and trials, case studies, the impact of lifestyle modification, and similar academic material of interest to the practitioner. While preference is given to material of immediate practical concern, the science that underpins lipidology is forwarded by expert contributors so that evidence-based approaches to reducing cardiovascular and coronary heart disease can be made immediately available to our readers. Sections of the Journal will address pioneering studies and the clinicians who conduct them, case studies, ethical standards and conduct, professional guidance such as ATP and NCEP, editorial commentary, letters from readers, National Lipid Association (NLA) news and upcoming event information, as well as abstracts from the NLA annual scientific sessions and the scientific forums held by its chapters, when appropriate.
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