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Ready, Set, Change! Development and usability testing of an online readiness for change decision support tool for healthcare organizations

机译:准备,设置,更改!针对医疗保健组织的在线变更准备决策支持工具的开发和可用性测试

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To address challenges related to selecting a valid, reliable, and appropriate readiness assessment measure in practice, we developed an online decision support tool to aid frontline implementers in healthcare settings in this process. The focus of this paper is to describe a multi-step, end-user driven approach to developing this tool for use during the planning stages of implementation. A multi-phase, end-user driven approach was used to develop and test the usability of a readiness decision support tool. First, readiness assessment measures that are valid, reliable, and appropriate for healthcare settings were identified from a systematic review. Second, a mapping exercise was performed to categorize individual items of included measures according to key readiness constructs from an existing framework. Third, a modified Delphi process was used to collect stakeholder ratings of the included measures on domains of feasibility, relevance, and likelihood to recommend. Fourth, two versions of a decision support tool prototype were developed and evaluated for usability. Nine valid and reliable readiness assessment measures were included in the decision support tool. The mapping exercise revealed that of the nine measures, most measures (78?%) focused on assessing readiness for change at the organizational versus the individual level, and that four measures (44?%) represented all constructs of organizational readiness. During the modified Delphi process, stakeholders rated most measures as feasible and relevant for use in practice, and reported that they would be likely to recommend use of most measures. Using data from the mapping exercise and stakeholder panel, an algorithm was developed to link users to a measure based on characteristics of their organizational setting and their readiness for change assessment priorities. Usability testing yielded recommendations that were used to refine the Ready, Set, Change! decision support tool . Ready, Set, Change! decision support tool is an implementation support that is designed to facilitate the routine incorporation of a readiness assessment as an early step in implementation. Use of this tool in practice may offer time and resource-saving implications for implementation.
机译:为了解决与在实践中选择有效,可靠和适当的就绪评估方法有关的挑战,我们开发了一种在线决策支持工具,以在此过程中协助一线实施人员在医疗机构中开展工作。本文的重点是描述一种最终用户驱动的多步骤方法,以开发此工具以在实施的规划阶段使用。使用多阶段,最终用户驱动的方法来开发和测试就绪决策支持工具的可用性。首先,从系统评价中确定了有效,可靠和适合医疗机构的准备评估措施。其次,根据现有框架中的关键准备结构,进行了映射练习,对包含措施的各个项目进行了分类。第三,采用改进的Delphi流程收集利益相关者对所包括措施的可行性,相关性和推荐可能性领域的评级。第四,开发了两个版本的决策支持工具原型,并对其可用性进行了评估。决策支持工具中包括九种有效和可靠的准备状态评估措施。测绘工作表明,在这九项措施中,大多数措施(78%)侧重于评估组织与个人层面上变革的准备程度,而四项措施(44%)代表了组织准备的所有构成。在经过修改的Delphi流程中,利益相关者将大多数措施评定为可行并与实际使用相关,并报告他们可能会建议大多数措施的使用。利用映射活动和利益相关者面板中的数据,开发了一种算法,可根据用户的组织设置特征和他们对变更评估优先级的准备程度,将用户链接到一项度量。可用性测试提出了一些建议,这些建议用于完善“准备,设置,更改”!决策支持工具。准备,设置,更改!决策支持工具是一种实施支持,旨在促进常规情况下纳入准备情况评估,以作为实施的早期步骤。在实践中使用此工具可能为实施带来时间和资源节约的意义。

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