Abstract：
BACKGROUND:Research regarding the decision to adopt and implement technological innovations in radiation oncology is lacking. This is particularly problematic since these technologies are often complex and rapidly evolving, requiring ongoing revisiting of decisions regarding which technologies are the most appropriate to support. Variations in adoption and implementation decisions for new radiation technologies across cancer centres can impact patients' access to appropriate and innovative forms of radiation therapy. This study examines the key steps in the process of adopting and implementing intensity modulated radiation therapy (IMRT) in publicly funded cancer centres and identifies facilitating or impeding factors. METHODS:A multiple case study design, utilizing document analysis and key informant interviews was employed. Four cancer centres in Ontario, Canada were selected and interviews were conducted with radiation oncologists, medical physicists, radiation therapists, and senior administrative leaders. RESULTS:Eighteen key informants were interviewed. Overall, three centres made fair to excellent progress in the implementation of IMRT, while one centre achieved only limited implementation as of 2009. Key factors that influenced the extent of IMRT implementation were categorized as: 1) leadership, 2) training, expertise and standardization, 3) collaboration, 4) resources, and 5) resistance to change. CONCLUSION:A framework for the adoption and implementation of complex and evolving technologies is presented. It identifies the key factors that should be addressed by decision-makers at specific stages of the adoption/implementation process.
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Bak K,Dobrow MJ,Hodgson D,Whitton Adoi
10.1186/1472-6963-11-178subject
Has Abstractpub_date
2011-07-31 00:00:00pages
178issn
1472-6963pii
1472-6963-11-178journal_volume
11pub_type
杂志文章abstract：BACKGROUND:Strong evidence exists to support preoperative pelvic floor muscle training (PFMT) to reduce the severity and duration of urinary incontinence after radical prostatectomy. Receipt of preoperative PFMT amongst men having radical prostatectomy in Western Sydney, however, is suboptimal. This study was undertake...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/1472-6963-13-305
更新日期：2013-08-13 00:00:00
abstract：BACKGROUND:Discrete choice experiments (DCEs) are attribute-driven experimental techniques used to elicit stakeholders' preferences to support the design and implementation of policy interventions. The validity of a DCE, therefore, depends on the appropriate specification of the attributes and their levels. There have ...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/1472-6963-14-235
更新日期：2014-05-22 00:00:00
abstract：BACKGROUND:The motivation for this study was to investigate how role stress among nurses could affect their job satisfaction and organizational commitment, and whether the job rotation system might encourage nurses to understand, relate to and share the vision of the organization, consequently increasing their job sati...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/1472-6963-9-8
更新日期：2009-01-12 00:00:00
abstract：:This paper describes the first phase of the LINKIN Health Study, which aims to evaluate health system functioning within a rural population. Locally relevant data on the health status and service usage of this population, including non-users and users, health service providers traditionally omitted from health service...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/1472-6963-12-321
更新日期：2012-09-18 00:00:00
abstract：BACKGROUND:Ethiopia has been deploying specially trained new cadres of community based health workers in urban areas of the country known as urban health extension professionals since 2009. At present, relatively little work has focused on understanding to what extent this new program is accepted and used by the commun...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-017-2129-z
更新日期：2017-03-14 00:00:00
abstract：BACKGROUND:Psychosocial job characteristics require nursing staff with high self-consistency and good mental health. However, the attention and effort of such study remained very limited in China. METHODS:A self-administered questionnaire was distributed to the bedside nurses in an affiliated hospital of Hebei Medical...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-016-1463-x
更新日期：2016-06-28 00:00:00
abstract：BACKGROUND:Rates of noncommunicable diseases (NCDs) such as type 2 diabetes are escalating in low and middle-income countries such as Brazil. Scalable primary care-based interventions are needed to improve self-management and clinical outcomes of adults with diabetes. This pilot study examines the feasibility, acceptab...
journal_title：BMC health services research
pub_type： 临床试验,杂志文章
doi：10.1186/s12913-016-1968-3
更新日期：2017-01-13 00:00:00
abstract：BACKGROUND:Training is a critical part of health information technology implementations, but little emphasis is placed on post-implementation training to support day-to-day activities. The goal of this study was to evaluate the impact of post-implementation training on key electronic health record activities. METHODS:...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/1472-6963-13-503
更新日期：2013-12-02 00:00:00
abstract：BACKGROUND:The Stroke Canada Optimization of Rehabilitation by Evidence Implementation Trial (SCORE-IT) was a cluster randomized controlled trial that evaluated two knowledge translation (KT) interventions for the promotion of the uptake of best practice recommendations for interventions targeting upper and lower extre...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-017-2389-7
更新日期：2017-06-26 00:00:00
abstract：BACKGROUND:The poor physical health of people with severe mental illness (SMI) is often attributed to lifestyle, disease-related medication side effects and disparate provision of healthcare. The complexity and inexact nature of this issue prohibits the identification of a clear and concise causal pathway, which in tur...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-015-0744-0
更新日期：2015-03-03 00:00:00
abstract：BACKGROUND:This article presents the qualitative component linked to a larger study of implementation of the Xpert™ MTB/Rif technology in two Brazilian cities. Despite intrinsic advantages of new health technologies, its introduction can be disruptive to existing routines, and it is thus important to understand how the...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-015-0941-x
更新日期：2015-07-21 00:00:00
abstract：BACKGROUND:Health practitioners frequently encounter dying, death and suffering. While providing health care can be stressful, the literature on how different health practitioners cope with the emotional challenges associated with their work is sparse. Further, much of this literature is based on studies conducted in h...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-017-2646-9
更新日期：2017-12-04 00:00:00
abstract：BACKGROUND:Clinicians informally assess changes in patients' status over time to prognosticate their outcomes. The incorporation of trends in patient status into regression models could improve their ability to predict outcomes. In this study, we used a unique approach to measure trends in patient hospital death risk a...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/1472-6963-11-171
更新日期：2011-07-21 00:00:00
abstract：BACKGROUND:Even if a large proportion of physiotherapists work in the private sector worldwide, very little is known of the organizations within which they practice. Such knowledge is important to help understand contexts of practice and how they influence the quality of services and patient outcomes. The purpose of th...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/1472-6963-14-362
更新日期：2014-08-29 00:00:00
abstract：BACKGROUND:Due to a continuing age shift in the German society hospital providers are concerned about the additional costs associated with the treatment of elderly patients. It is not clear if cardiac catheterization in aged patients leads to higher resource utilization and if DRG-revenues do compensate for this factor...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-017-1999-4
更新日期：2017-01-18 00:00:00
abstract：BACKGROUND:To evaluate the cost-effectiveness of a reduction in the number of routine radiographs in the follow-up of patients with ankle fractures. METHODS:We performed an economic evaluation alongside the multicentre, randomised WARRIOR trial. Participants were randomised to a reduced imaging follow-up protocol (i.e...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-020-05725-1
更新日期：2020-09-22 00:00:00
abstract：BACKGROUND:Quality indicators (QI) are used in health care to measure quality of service and performance improvement. Health care professionals and organizations caring for patients with injuries need information regarding the quality of care provided and the outcomes experienced in order to target improvement efforts....
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/1472-6963-13-31
更新日期：2013-01-27 00:00:00
abstract：BACKGROUND:Societal preferences have to be taken into consideration to ensure difficult healthcare decisions are legitimate and acceptable. It has been interesting to ascertain whether attitudes towards the principles of public healthcare resources allocation are homogenous. In particular, it has been thought provoking...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-015-1210-8
更新日期：2015-12-18 00:00:00
abstract：BACKGROUND:Older people have higher rates of hospital admission than the general population and higher rates of readmission due to complications and falls. During hospitalisation, older people experience significant functional decline which impairs their future independence and quality of life. Acute hospital services ...
journal_title：BMC health services research
pub_type： 杂志文章,随机对照试验
doi：10.1186/1472-6963-11-202
更新日期：2011-08-23 00:00:00
abstract：BACKGROUND:Control of obesity is an important priority to reduce the burden of chronic disease. Clinical guidelines focus on the role of primary healthcare in obesity prevention. The purpose of this scoping review is to examine what the published literature indicates about the role of hospital and community based healt...
journal_title：BMC health services research
pub_type： 杂志文章,评审
doi：10.1186/s12913-019-4262-3
更新日期：2019-07-05 00:00:00
abstract：BACKGROUND:Accurate and valid measures for implementation constructs are critical to advance research and guide implementation efforts. However, there is a continued need for valid and reliable measures for implementation research. The purpose of this study was to assess the psychometric properties of measures for the ...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-019-4021-5
更新日期：2019-03-29 00:00:00
abstract：BACKGROUND:Payers and policy makers across the international healthcare market are increasingly using publicly available summary measures to designate providers as "high-performing", but no consistently-applied approach exists to identifying high performers. This paper uses publicly available data to examine how differ...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-019-4293-9
更新日期：2019-07-18 00:00:00
abstract：BACKGROUND:Acute low back pain is one of the most common reasons for individuals to seek medical care in the United States. The US Military Health System provides medical care to approximately 9.4 million beneficiaries annually. These patients also routinely suffer from acute low back pain. Within this health system, p...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-018-3525-8
更新日期：2018-09-17 00:00:00
abstract：BACKGROUND:Most health care services are provided in the primary health care sector, and an increasing number of elderly is in need of these services. Nonetheless, the research on patient safety culture in home care services and nursing homes remains scarce. This study describes staff perceptions of patient safety cult...
journal_title：BMC health services research
pub_type： 杂志文章,多中心研究
doi：10.1186/s12913-019-4456-8
更新日期：2019-08-29 00:00:00
abstract：BACKGROUND:Tort law has legitimate social purposes of deterrence, punishment and compensation, but medical tort law does none of these well. Tort law could be counterproductive in medicine, encouraging costly defensive practices that harm some patients, restricting access to care in some settings and discouraging innov...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/1472-6963-10-150
更新日期：2010-06-02 00:00:00
abstract：BACKGROUND:The health care delivery system in the United States is facing cost and quality pressures that will require fundamental changes to remain viable. The optimal structures of the relationships between the hospital, medical school, and physicians have not been determined but are likely to have a large impact on ...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/1472-6963-9-57
更新日期：2009-04-01 00:00:00
abstract：BACKGROUND:Small Canadian rural maternity services are struggling to maintain core staffing and remain open. Existing evidence states that having to travel to access maternity services is associated with adverse outcomes. The goal of this study is to systematically examine rural maternal and newborn outcomes across thr...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-015-1034-6
更新日期：2015-09-23 00:00:00
abstract：BACKGROUND:Evidence-Based Medicine (EBM) is an important method used by occupational physicians (OPs) to deliver high quality health care. The presence and quality of a knowledge infrastructure is thought to influence the practice of EBM in occupational health care. This study explores the facilities in the knowledge i...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/1472-6963-9-18
更新日期：2009-01-30 00:00:00
abstract：BACKGROUND:Management, culture and systems for better quality and patient safety in hospitals have been widely studied in Norway. Nursing homes and home care, however have received much less attention. An increasing number of people need health services in nursing homes and at home, and the services are struggling with...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-020-05149-x
更新日期：2020-04-03 00:00:00
abstract：BACKGROUND:Ocular conditions are common following stroke and frequently occur in combination with pre-existing ophthalmologic disease. The Medicare International Statistical Classification of Diseases and Related Health Problems (ICD-10) coding system for identifying vision related health conditions provides a much hig...
journal_title：BMC health services research
pub_type： 杂志文章
doi：10.1186/s12913-020-05484-z
更新日期：2020-07-08 00:00:00
