Reducing work pressure and IT problems and facilitating IT integration and audit & feedback help adherence to perioperative safety guidelines: a survey among 95 perioperative professionals.

Guideline adherence Implementation Implementation barriers Implementation facilitators Patient safety Perioperative care

Journal

Implementation science communications
ISSN: 2662-2211
Titre abrégé: Implement Sci Commun
Pays: England
ID NLM: 101764360

Informations de publication

Date de publication:
2020
Historique:
received: 19 09 2019
accepted: 29 04 2020
entrez: 5 9 2020
pubmed: 5 9 2020
medline: 5 9 2020
Statut: epublish

Résumé

To improve perioperative patient safety, guidelines for the preoperative, peroperative, and postoperative phase were introduced in the Netherlands between 2010 and 2013. To help the implementation of these guidelines, we aimed to get a better understanding of the barriers and drivers of perioperative guideline adherence and to explore what can be learned for future implementation projects in complex organizations. We developed a questionnaire survey based on the theoretical framework of Van Sluisveld et al. for classifying barriers and facilitators. The questionnaire contained 57 statements derived from (a) an instrument for measuring determinants of innovations by the Dutch Organization for Applied Scientific Research, (b) interviews with quality and safety policy officers and perioperative professionals, and (c) a publication of Cabana et al. The target group consisted of 232 perioperative professionals in nine hospitals. In addition to rating the statements on a five-point Likert scale (which were classified into the seven categories of the framework: factors relating to the intervention, society, implementation, organization, professional, patients, and social factors), respondents were invited to rank their three most important barriers in a separate, extra open-ended question. Ninety-five professionals (41%) completed the questionnaire. Fifteen statements (26%) were considered to be barriers, relating to social factors ( We identified a wide range of barriers that are believed to hinder the use of the perioperative safety guidelines, while an integrated information system and local data collection and feedback will also be necessary to engage perioperative teams. These barriers need to be locally prioritized and addressed by tailored implementation strategies. These results may also be of relevance for guideline implementation in general in complex organizations. Dutch Trial Registry: NTR3568.

Sections du résumé

BACKGROUND BACKGROUND
To improve perioperative patient safety, guidelines for the preoperative, peroperative, and postoperative phase were introduced in the Netherlands between 2010 and 2013. To help the implementation of these guidelines, we aimed to get a better understanding of the barriers and drivers of perioperative guideline adherence and to explore what can be learned for future implementation projects in complex organizations.
METHODS METHODS
We developed a questionnaire survey based on the theoretical framework of Van Sluisveld et al. for classifying barriers and facilitators. The questionnaire contained 57 statements derived from (a) an instrument for measuring determinants of innovations by the Dutch Organization for Applied Scientific Research, (b) interviews with quality and safety policy officers and perioperative professionals, and (c) a publication of Cabana et al. The target group consisted of 232 perioperative professionals in nine hospitals. In addition to rating the statements on a five-point Likert scale (which were classified into the seven categories of the framework: factors relating to the intervention, society, implementation, organization, professional, patients, and social factors), respondents were invited to rank their three most important barriers in a separate, extra open-ended question.
RESULTS RESULTS
Ninety-five professionals (41%) completed the questionnaire. Fifteen statements (26%) were considered to be barriers, relating to social factors (
CONCLUSIONS CONCLUSIONS
We identified a wide range of barriers that are believed to hinder the use of the perioperative safety guidelines, while an integrated information system and local data collection and feedback will also be necessary to engage perioperative teams. These barriers need to be locally prioritized and addressed by tailored implementation strategies. These results may also be of relevance for guideline implementation in general in complex organizations.
TRIAL REGISTRATION BACKGROUND
Dutch Trial Registry: NTR3568.

Identifiants

pubmed: 32885205
doi: 10.1186/s43058-020-00037-1
pii: 37
pmc: PMC7427904
doi:

Types de publication

Journal Article

Langues

eng

Pagination

49

Informations de copyright

© The Author(s) 2020.

Déclaration de conflit d'intérêts

Competing interestsThe authors have no competing interests to declare.

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Auteurs

Yvette E J J M Emond (YEJJM)

Radboudumc, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands.
Radboudumc, Radboud Institute for Health Sciences, Department of Anesthesiology, Pain and Palliative Care, Nijmegen, The Netherlands.
Radboudumc, IQ healthcare, PO Box 9101, 114 IQ healthcare, 6500 HB Nijmegen, The Netherlands.

André P Wolff (AP)

University Medical Center Groningen, University of Groningen, Department of Anesthesiology, Pain Center, Groningen, The Netherlands.

Yvonne A S Peters (YAS)

Radboudumc, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands.

Gerrit J A Bloo (GJA)

Radboudumc, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands.
Radboudumc, Radboud Institute for Health Sciences, Department of Anesthesiology, Pain and Palliative Care, Nijmegen, The Netherlands.

Gert P Westert (GP)

Radboudumc, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands.

Johan Damen (J)

Radboudumc, Radboud Institute for Health Sciences, Department of Anesthesiology, Pain and Palliative Care, Nijmegen, The Netherlands.

Hiske Calsbeek (H)

Radboudumc, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands.

Hub C Wollersheim (HC)

Radboudumc, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands.

Classifications MeSH