Implementation of cancer screening in rural primary care practices after joining an accountable care organisation:a multiple case study
作者机构：School of NursingUniversity of Kansas Medical CenterKansas CityKansasUSA University of Kansas Cancer CenterUniversity of Kansas Medical CenterKansas CityKansasUSA Population HealthUniversity of Kansas Medical CenterKansas CityKansasUSA Family MedicineUniversity of Kansas Medical CenterKansas CityKansasUSA
出 版 物：《Family Medicine and Community Health》 (家庭医学与社区卫生（英文）)
年 卷 期：2021年第9卷第4期
页 面：42-49,I0013,I0014,I0015页
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
基 金：funded by the National Cancer Institute of the National Institutes of Health grant number P30CA168524-07S3
摘 要：Objective To describe common strategies and practice-specific barriers,adaptations and determinants of cancer screening implementation in eight rural primary care practices in the Midwestern United States after joining an accountable care organisation(ACO).Design This study used a multiple case study *** sampling was used to identify a diverse group of practices within the *** were collected from focus group interviews and workflow *** Consolidated Framework for Implementation Research(CFIR)was used to guide data collection and *** were cross-analysed by clinic and CFIR domains to identify common themes and practice-specific determinants of cancer screening *** The study included eight rural primary care practices,defined as Rural-Urban Continuum Codes 5-9,in one ACO in the Midwestern United *** Providers,staff and administrators who worked in the primary care practices participated in focus groups.28 individuals participated including 10 physicians;one doctor of osteopathic medicine;three advanced practice registered nurses;eight registered nurses,quality assurance and licensed practical nurses;one medical assistant;one care coordination manager;and four *** With integration into the ACO,practices adopted four new strategies to support cancer screening:care gap lists,huddle sheets,screening via annual wellness visits and information ***-case analysis revealed that all practices used both visit-based and population-based cancer screening strategies,although workflows varied widely across *** of the four strategies was adapted for fit to the local context of the *** shared that joining the ACO provided a strong external incentive for increasing cancer screening *** predominant determinants of cancer screening success at the clinic level were use of the electronic health record(EHR)and fully engaging nurses in the screening ***
维普期刊数据库