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首页> 外文期刊>Implementation Science >Toward systematic reviews to understand the determinants of wait time management success to help decision-makers and managers better manage wait times
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Toward systematic reviews to understand the determinants of wait time management success to help decision-makers and managers better manage wait times

机译：进行系统评价以了解等待时间管理成功的决定因素，以帮助决策者和经理更好地管理等待时间

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Background Long waits for core specialized services have consistently been identified as a key barrier to access. Governments and organizations at all levels have responded with strategies for better wait list management. While these initiatives are promising, insufficient attention has been paid to factors influencing the implementation and sustainability of wait time management strategies (WTMS) implemented at the organizational level. Methods A systematic review was conducted using the main electronic databases, such as CINAHL, MEDLINE, and Cochrane Database of Systematic Reviews, to identify articles published between 1990 and 2011 on WTMS for scheduled care implemented at the organizational level or higher and on frameworks for analyzing factors influencing their success. Data was extracted on governance, culture, resources, and tools. We organized a workshop with Canadian healthcare policy-makers and managers to compare our initial findings with their experience. Results Our systematic review included 47 articles: 36 related to implementation and 11 to sustainability. From these, we identified a variety of WTMS initiated at the organizational level or higher, and within these, certain factors that were specific to either implementation or sustainability and others common to both. The main common factors influencing success at the contextual level were stakeholder engagement and strong funding, and at the organizational level, physician involvement, human resources capacity, and information management systems. Specific factors for successful implementation at the contextual level were consultation with front-line actors and common standards and guidelines, and at the organizational level, financial incentives and dedicated staffing. For sustainability, we found no new factors. The workshop participants identified the same major factors as found in the articles and added others, such as information sharing between physicians and managers. Conclusions Factors related to implementation were studied more than those related to sustainability. However, this finding was useful in developing a tool to help managers at the local level monitor the implementation of WTMS and highlighted the need for more research on specific factors for sustainability and to assess the unintended consequences of introducing WTMS in healthcare organizations.
机译：背景技术长期以来，长期等待核心专业服务一直被认为是访问的主要障碍。各级政府和组织已经采取了对更好的候补名单管理的策略。尽管这些举措很有希望，但对组织级别实施的等待时间管理策略（WTMS）的实施和可持续性的影响尚未引起足够的重视。方法使用CINAHL，MEDLINE和Cochrane系统评价数据库等主要电子数据库进行系统评价，以鉴定1990年至2011年间在WTMS上发表的，在组织级别或更高级别实施的定期护理以及有关分析框架的文章影响其成功的因素。提取了有关治理，文化，资源和工具的数据。我们与加拿大医疗保健政策制定者和经理组织了一个研讨会，以比较我们的初步发现和他们的经验。结果我们的系统评价包括47篇文章：36篇与实施相关，11篇与可持续性相关。通过这些，我们确定了在组织级别或更高级别发起的各种WTMS，并且在这些级别中，某些特定于实施或可持续性的因素以及两者共同的其他因素。在上下文级别影响成功的主要共同因素是利益相关者的参与和强大的资金，在组织级别，医师的参与，人力资源能力和信息管理系统。在上下文一级成功实施的具体因素是与一线行动者，共同的标准和准则以及组织一级的磋商，财务激励措施和专门的人员编制。对于可持续性，我们没有发现新因素。研讨会的参与者确定了与文章中相同的主要因素，并添加了其他因素，例如医师和管理者之间的信息共享。结论与实施有关的因素比与可持续性有关的因素受到了更多的研究。但是，这一发现有助于开发一种工具，以帮助地方管理人员监控WTMS的实施，并强调需要对可持续性的具体因素进行更多研究，并评估将WTMS引入医疗机构的意外后果。

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