دورية أكاديمية
The role of professional logics in quality register use: a realist evaluation.
| العنوان: | The role of professional logics in quality register use: a realist evaluation. |
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| المؤلفون: | Norman AC; Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Box 1026, SE-551 11, Jönköping, Sweden. ann-charlott.norman@regionuppsala.se., Elg M; Department of Management and Engineering, HELIX Competence Centre, Linköping University, Linköping, Sweden., Nordin A; Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Box 1026, SE-551 11, Jönköping, Sweden., Gäre BA; Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Box 1026, SE-551 11, Jönköping, Sweden.; Futurum, Academy for Health and Care Region Jönköping County, Ryhov County Hospital, Jönköping, Sweden., Algurén B; Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Box 1026, SE-551 11, Jönköping, Sweden.; Department of Food and Nutrition, and Sport Science, Faculty of Education, University of Gothenburg, Gothenburg, Sweden. |
| المصدر: | BMC health services research [BMC Health Serv Res] 2020 Feb 11; Vol. 20 (1), pp. 107. Date of Electronic Publication: 2020 Feb 11. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: London : BioMed Central, [2001- |
| مواضيع طبية MeSH: | Logic* , Quality Improvement* , Registries*, Health Services Research ; Humans ; Sweden |
| مستخلص: | Background: Clinical practice improvements based on quality-register data are influenced by multiple factors. Although there is agreement that information from quality registers is valuable for quality improvement, practical ways of organising register use have been notoriously difficult to realise. The present study sought to investigate the mechanisms that lead various clinicians to use quality registers for improvement. Methods: This research involves studying individuals' decisions in response to a Swedish programme focusing on increasing the use of quality registers. Through a case study, we focused on heart failure care and its corresponding register: the Swedish Heart Failure Register. The empirical data consisted of a purposive sample collected longitudinally by qualitative methods between 2013 and 2015. In total, 18 semi-structured interviews were carried out. We used realist evaluation to identify contexts, mechanisms, and outcomes. Results: We identified four contexts - registration, use of output data, governance, and improvement projects - that provide conditions for the initiation of specific mechanisms. Given a professional theoretical perspective, we further showed that mechanisms are based on the logics of either organisational improvement or clinical practice. The two logics offer insights into the ways in which clinicians choose to embrace or reject certain registers' initiatives. Conclusions: We identified a strong path dependence, as registers have historically been tightly linked to the medical profession's competence. Few new initiatives in the studied programme reach the clinical context. We explain this through the lack of an organisational improvement logic and its corresponding mechanisms in the context of the medical profession. Implementation programmes must understand the logic of clinical practice; that is, be integrated with the ways in which work is carried out in everyday practice. Programmes need to be better at helping core health professionals to reach the highest standards of patient care. |
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| معلومات مُعتمدة: | 2012/743(261) Sveriges Kommuner och Landsting |
| فهرسة مساهمة: | Keywords: Clinical practice; Professional logics; Programme; Quality registers; Realist evaluation |
| تواريخ الأحداث: | Date Created: 20200213 Date Completed: 20200522 Latest Revision: 20200522 |
| رمز التحديث: | 20240628 |
| مُعرف محوري في PubMed: | PMC7014753 |
| DOI: | 10.1186/s12913-020-4944-x |
| PMID: | 32046710 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1472-6963 |
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| DOI: | 10.1186/s12913-020-4944-x |