利用实施科学确定NEST360的模式和结果,以提高该联盟的质量。NEST360是一个旨在降低撒哈拉以南非洲新生儿死亡率的多国联盟。

IF 5.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Kylie Dougherty, Nebiyou Hailemariam, Georgia Jenkins, Junwei Chen, Jackson Ilangali, John Mwangi, Julius Thomas, Hannah Mwaniki Mwaniki, Olabisi Dosunmu, Robert Tillya, Samuel Ngwala, Joy E Lawn, Rebecca Richards-Kortum, Z Maria Oden, Christine Bohne, Lisa R Hirschhorn
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引用次数: 0

摘要

背景:在资源有限的环境中,改善小病新生儿护理(SSNC)至关重要。新生儿基本解决方案和技术(NEST360)是一个多国联盟,旨在通过循证干预措施降低新生儿死亡率。NEST360开发了一种多管齐下的方法来提高质量。我们使用实施研究(IR)来描述这种方法并报告新出现的实施结果。方法:应用实施研究逻辑模型(IRLM)将情境因素、实施策略、机制和实施结果联系起来,捕捉质量改进方法的成功与挑战。数据来源包括方案数据、同行评议出版物和团队投入。背景因素由NEST360-UNICEF SSNC实施工具包组织。战略按照实施变更专家建议列表进行分组,实施结果使用Proctor的实施结果进行测量。结果:我们开发了一个IRLM来描述NEST360改进质量模型的实施。该IRLM包括33个语境因素;42%是障碍,42%是促进者,15%既是障碍又是促进者。此外,我们确定了NEST360使用的10个实施策略。逻辑模型还描述了上下文因素、处理这些因素的策略和初步实现结果之间的联系。测量结果的例子包括:100%的单元至少登录一次nest360 -实施跟踪器(NEST-IT)(2023年10月至2024年3月),100%的单元执行质量改进(QI)项目(2024年4月至2024年6月),以及93%的单元在其QI项目文档中报告NEST-IT数据的可行性(2024年4月至2024年6月)。最后,本研究确定了可持续发展战略是一项关键需求。结论:整合IR和QI可提高资源有限环境下的SSNC。解决障碍、利用促进器和使用结构化IR框架推进了QI工作,从而在为高质量医疗保健构建可扩展系统的同时,提高了干预措施的覆盖范围、采用率和可行性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Using implementation science to define the model and outcomes for improving quality in NEST360, a multicountry alliance for reducing newborn mortality in sub-Saharan Africa.

Background: Improving small and sick newborn care (SSNC) is crucial in resource-limited settings. Newborn Essential Solutions and Technologies (NEST360), a multicountry alliance, aims to reduce newborn mortality through evidence-based interventions. NEST360 developed a multipronged approach to improving quality. We use implementation research (IR) to describe this approach and report emerging implementation outcomes.

Methods: The implementation research logic model (IRLM) was applied to link contextual factors, implementation strategies, mechanisms and implementation outcomes, capturing successes and challenges of the improving quality approach. Data sources included programme data, peer-reviewed publications and team input. Contextual factors were organised by the NEST360-UNICEF SSNC implementation toolkit. Strategies were grouped by the Expert Recommendations for Implementation Change list, and implementation outcomes were measured using Proctor's implementation outcomes.

Results: We developed an IRLM to describe the implementation of NEST360's improving quality model. This IRLM included 33 contextual factors; 42% were barriers, 42% were facilitators, and 15% were both a barrier and facilitator. Additionally, we identified 10 implementation strategies that NEST360 used. The logic model also describes the connections between the contextual factors, the strategies that address them, and the preliminary implementation outcomes. Examples of the outcomes measured include Reach with 100% of units logging into the NEST360-Implementation Tracker (NEST-IT) at least once (October 2023 to March 2024), Adoption with 100% of units conducting a quality improvement (QI) project (April 2024 to June 2024), and Feasibility with 93% of units reporting NEST-IT data in their QI project documentation (April 2024 to June 2024). Finally, this study identified sustainability strategies as a critical need.

Conclusions: Integrating IR and QI enhances SSNC in resource-limited settings. Addressing barriers, leveraging facilitators and using structured IR frameworks advanced QI efforts, thereby improving intervention reach, adoption and feasibility while building scalable systems for high-quality healthcare.

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来源期刊
BMJ Quality & Safety
BMJ Quality & Safety HEALTH CARE SCIENCES & SERVICES-
CiteScore
9.80
自引率
7.40%
发文量
104
审稿时长
4-8 weeks
期刊介绍: BMJ Quality & Safety (previously Quality & Safety in Health Care) is an international peer review publication providing research, opinions, debates and reviews for academics, clinicians and healthcare managers focused on the quality and safety of health care and the science of improvement. The journal receives approximately 1000 manuscripts a year and has an acceptance rate for original research of 12%. Time from submission to first decision averages 22 days and accepted articles are typically published online within 20 days. Its current impact factor is 3.281.
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