Susan Saldanha, Riki Lane, Sharon Clifford, Prisha Dadoo, Chris Barton, Grant Russell
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摘要

背景 正式的临床路径已成为将证据转化为临床建议的流行方法,并根据当地的医疗环境量身定制。近年来,HealthPathways 平台已被用于在新西兰和澳大利亚实施一系列临床和转诊路径。尽管HealthPathways被广泛采用,但人们对影响其在澳大利亚全科医疗中持续使用的因素知之甚少。方法 本定性研究在墨尔本初级医疗网络的三个集水区进行,采用规范化过程理论来探讨HealthPathways的实施情况。我们对 43 名参与者进行了半结构化访谈,其中包括全科医生 (GP)、执业护士、执业经理、初级卫生网络工作人员和主要地区信息提供者。分析结合了归纳法和演绎法。结果 研究结果表明,尽管 "健康之路 "有望提高临床实践水平,但由于人们对它的认知度较低,而且初级卫生网络覆盖范围内的整合情况各不相同,因此目前对它的采用和影响都很有限。新近毕业的医学专业学生认为,它有助于帮助患者获得适当的医疗服务。尽管已有的全科医生抵制变革,但同行的建议和时间限制对采用该系统产生了影响。有针对性的教育、有效的推广和改进的监测系统被认为是促进更广泛、更有效地使用健康之路的关键,最终有助于改善患者护理和简化临床流程。结论 尽管健康之路的相对正常化是显而易见的,但整合方面的挑战依然存在,需要有针对性的策略。向全科医生全面推广、在全澳大利亚实现标准化以及加强数字界面之间的技术互操作性至关重要。强有力的合作伙伴关系和反馈机制可以优化健康之路对患者护理的影响,支持澳大利亚国家初级医疗保健十年计划的目标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Factors influencing uptake and sustained utility of HealthPathways in Australian general practice: a qualitative study.

Background Formalised clinical pathways have become popular approaches to translate evidence into clinical recommendations, tailored for the local healthcare setting. In recent years, the HealthPathways platform has been used to implement a range of clinical and referral pathways in New Zealand and Australia. Despite widespread adoption, little is known of factors influencing the sustained use of HealthPathways in Australian general practice. Methods This qualitative study, conducted in three Melbourne Primary Health Network catchments, applied normalisation process theory to explore HealthPathways implementation. We conducted semi-structured interviews with 43 participants, including general practitioners (GPs), practice nurses, practice managers, Primary Health Network staff and key regional informants. Analysis combined inductive and deductive approaches. Results The findings suggest that although HealthPathways holds promise for enhancing clinical practice, its adoption and impact are currently limited due to low awareness and varied integration across Primary Health Network catchments. Recent medical graduates found it useful for helping patients access appropriate care. Adoption was influenced by peer recommendations and time constraints, although established GPs resisted change. Targeted education, effective promotion and improved monitoring systems were identified as crucial to facilitate wider and more effective use of HealthPathways, ultimately contributing to better patient care and streamlined clinical processes. Conclusion Although HealthPathways' relative normalisation is evident, challenges in integration persist, requiring targeted strategies. Comprehensive promotion to GPs, standardisation across Australia and enhancing technical interoperability between digital interfaces is essential. Strong partnerships and feedback mechanisms can optimise HealthPathways' impact on patient care, supporting the objectives of the Australian National Primary Health Care 10-year plan.

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