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Implementing point-of-care medical information systems into trauma and general surgeon practice in a middle-income country: a qualitative study utilizing the Consolidated Framework for Implementation Research

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dc.contributor.author Wilson, Stephanie N.
dc.contributor.author Noble, Helen
dc.contributor.author Neumann Ordoñez, Willy Jesús
dc.contributor.author Zavala Wong, Gabriela
dc.contributor.author Rodríguez Castro, Manuel Jorge Augusto
dc.contributor.author Ortega Checa, David
dc.contributor.author Warne, Maria
dc.contributor.author Senturia, Kirsten
dc.contributor.author LaGrone, Lacey Nicole
dc.coverage.spatial Lima, Perú
dc.date.accessioned 2023-04-16T04:38:14Z
dc.date.available 2023-04-16T04:38:14Z
dc.date.issued 2023
dc.identifier.uri https://hdl.handle.net/20.500.12866/13385
dc.description.abstract Background Point-of-care medical information systems (POCMIS) can provide an efficient and effective means of strengthening health systems globally through their encouragement of continued medical education. Using the Consolidated Framework for Implementation Research (CFIR) as a guide, this research provides suggestions for improved implementation of POCMIS in low- and middle-income countries informed by an intervention implemented across public and military hospitals in Lima, Peru.MethodsAnalysis is based on qualitative interviews conducted with 12 Peruvian surgeons across eight public hospitals and one military hospital who received an intervention that provided free access to UpToDate and introduced Google Translate. The post-intervention interviews were transcribed, translated, and analyzed for themes overlapping with CFIR constructs to expose barriers to implementation and suggestions for improved implementation of future interventions.ResultsBarriers included a lack of seniority buy-in and engaged leadership, an overabundance of personal preferences for multiple POCMIS, and a culture of assumption that inhibited open communication regarding access to and use of POCMIS. Suggestions for improved implementation focused on the adaptation of the intervention. Namely, surgeons discussed regionally-specific adaptations as well as adaptations specific to their surgical specialty including visual, rather than written, representation of the information available via POCMIS.ConclusionsResults indicate necessary adaptations for implementing interventions including POCMIS in LMICs, mimicking much of the implementation science literature on intervention adaptation. In addition to explicit suggestions provided by surgeons, we also suggest actionable steps to adapt to barriers identified in our data. Rapid assessment procedures (RAP) are one established methodological technique useful for assessing organization culture prior to implementation, allowing for necessary cultural adaptations. Dynamic adaption process (DAP) is another useful and established method that breaks implementation into four phases allowing for adaptations based on the initial assessment of the intervention site. en_US
dc.language.iso eng
dc.publisher Springer
dc.relation.ispartofseries Implementation Science Communications
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Point-of-care en_US
dc.subject medical information systems en_US
dc.subject trauma surgeon en_US
dc.subject general surgeon en_US
dc.subject middle income country en_US
dc.subject qualitative study en_US
dc.title Implementing point-of-care medical information systems into trauma and general surgeon practice in a middle-income country: a qualitative study utilizing the Consolidated Framework for Implementation Research en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1186/s43058-023-00397-4
dc.relation.issn 2662-2211


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