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首页> 美国卫生研究院文献>The Permanente Journal >Using Implementation and Dissemination Concepts to Spread 21st-century Well-Child Care at a Health Maintenance Organization
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Using Implementation and Dissemination Concepts to Spread 21st-century Well-Child Care at a Health Maintenance Organization

机译：使用实施和传播概念在卫生维护组织中传播21世纪的儿童保育

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摘要

We describe here the use of a conceptual framework for implementing and disseminating in a Health Maintenance Organization an evidence-based model of well-child care (WCC) that includes developmental and preventive services recommended by the American Academy of Pediatrics. Twenty-first Century WCC is a parent-centered, team-based, primary care model that combines online previsit assessments—completed by parents and caregivers regarding clinic-based weight, growth, and development assessments—with vaccinations and anticipatory guidance. Nurses, nurse practitioners, developmental specialists, and pediatricians all play roles in the WCC model. Patient and clinician interaction, health records, and resources are all facilitated through a Web-based diagnostic, management, tracking, and resource information tool. Implementation and dissemination concepts and their attendant practices and tools can reliably be used to augment strategic decisions about how to best disseminate and implement innovations in health care delivery. Unlike innovations that are embedded only in technical systems, validated models of team-based health care have multiple components that must be made compatible with complex sociotechnical systems. Interpersonal communication, work, coordination, and judgment are key processes that affect implementation quality. Implementation can involve tailoring to a particular site and customizing either the model or the organizational context to accommodate it.
机译：我们在这里描述了使用概念框架在健康维护组织中实施和传播以证据为基础的良好儿童保育（WCC）模型，其中包括美国儿科学会推荐的发展和预防服务。二十一世纪WCC是一个以父母为中心，基于团队的初级保健模型，该模型结合了在线事前评估（由父母和看护人完成，涉及基于诊所的体重，生长和发育评估）以及疫苗接种和预期指导。护士，护士，发展专家和儿科医生都在WCC模型中扮演角色。通过基于Web的诊断，管理，跟踪和资源信息工具，可以促进患者和临床医生的互动，健康记录和资源。实施和传播的概念及其附带的实践和工具可以可靠地用于增强有关如何最好地传播和实施医疗保健创新的战略决策。与仅嵌入技术系统的创新不同，基于团队的医疗保健的经过验证的模型具有多个组件，必须使其与复杂的社会技术系统兼容。人际沟通，工作，协调和判断是影响实施质量的关键过程。实现可能涉及针对特定站点进行定制，并自定义模型或组织环境以适应该站点。

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