ObjectiveTo analyze the problems in the construction of internal control in colleges and universities, and to explore the implementation path suitable for colleges and universities. MethodsThe relevant documents on the internal control construction of universities at home and abroad were retrieved, and the case study of the implementation path of the internal control system construction of C university was analyzed by using the methods of expert interviews, flow charts and walk-through tests. ResultsThe internal control system of colleges and universities takes digital intelligence as the technical support to explore the implementation path of "external standard rule riveting point, internal standard post entry process; data standardization, process progress visualization; speed of operation tracking, data backtracking to find deviation; business data is all smooth, performance evaluation to promote management", optimize the process and improve the system, real-time extraction of operation data for key projects to track, and shorten the business operation time by more than half. ConclusionThe case university carries out empirical research on the internal control system, based on the principle of effective implementation, makes full use of the digital intelligence technology to extract the whole process data of the business system across the system, and realizes the efficient collaboration, early warning and evaluation, and scientific decision-making of the "digital intelligence" platform.
As evidence-based practice (EBP) continues to be valued, the guideline implementation has become an important field for research and practice in health care. In order to better guide the guideline implementation in the field of health care, this paper combines the EBP experience gained from several EBP programs carried out in our hospital those years, in aim of exploring and sharing the methodology of guideline implementation in domestic clinical settings.
To standardize and improve the reporting quality of digital health implementation research, the Geneva Digital Health Hub has developed the guidelines and checklist for reporting digital health implementations (iCHECK-DH). This paper introduces the background of iCHECK-DH and based on practical application experiences, emphasizes the importance of interdisciplinary collaboration. It focuses on economic cost-effectiveness and local policy guidance in the clinical implementation of digital health technologies. This will provide valuable insights for Chinese scholars when writing implementation reports on digital health technologies.
Implementation science is a systematic research approach that promotes the integration of research findings and evidence-based practices into routine clinical practice. It has been a crucial topic in scientific inquiry. As the notion of ‘implementation science’ has evolved and associated theoretical and practical methodologies have been refined, researchers in this field have devised implementation strategies to address the determinants of implementation (barriers and facilitators) for clinical interventions, evidence-based practices, or novel technologies in clinical practice. The development of implementation strategies aims to foster the adoption and dissemination of innovations. This article offers a comprehensive introduction to the definition of implementation strategies, the process of selecting appropriate implementation strategies, the associated documentation and reporting procedures, with the aim of providing valuable references for enhancing future implementation research efforts.
This article elaborates the concept, meaning and role of clinical pathway, discusses development stages and implementation effects of clinical pathway at home and abroad, and proposes that clinical pathway has been developed very well abroad, but it still has many problems in domestic gtowth which needs to be put into effect with Single-DRGs system in combination.
Objective To review main obstacles to health care professionals' adherence to clinical practice guidelines (CPGs) by employing the scoping review method and a determinants framework, and to explore the effect of implementation strategies in intervention researches on guideline adherence. Methods The articles published from January 1, 2011 to June 10, 2023 were retrieved from the PubMed, CINAHL, MEDLINE, Embase, Scopus, Cochrane Library, SinoMed, CNKI, WanFang Data and VIP databases. The original literature on the CPGs implementation obstacles and strategies was included, and the primary and secondary screening of the literature were completed by four researchers according to the inclusion and exclusion criteria. The basic characteristics of the literature, the factors affecting the implementation of the CPGs, and the strategies used were extracted. The results were analyzed and summarized using qualitative and quantitative methods. Results A total of 61 articles were included in the scoping review. The factors affecting the implementation of CPGs could be divided into five categories: guidelines themselves, external factors, internal factors, individual factors, and implementation process. The most common implementation obstacles were insufficient knowledge or skills of professionals regarding guidelines (n=21, 34.4%), insufficient necessity of using guidelines according to doctors (n=17, 27.9%), and unreasonable factors within hospital (n=16, 26.2%). The factors that promoted the implementation of CPGs included guidelines based on high-quality evidence (n=5, 8.2%), good department or hospital culture (n=4, 6.6%), convenient accessibility of guideline knowledge and information (n=4, 6.6%), and doctors’ excellent professional ability (n=4, 6.6%). The overall effectiveness of the guideline implementation strategy was 50%. Clinical decision support system (CDSS) could improve the adherence of CPGs. Guideline education or training was one of the most commonly used methods, but the effect of improving guideline compliance was unstable. Conclusion The primary challenges in implementing guidelines include inadequate professional capacity and demand, suboptimal hospital infrastructure and limited resources. However, the obstacles are not absolute. It is recommended to use implementation strategies to improve the absorption and implementation of guidelines, among which CDSS is an effective measure for promoting guideline adherence.
N-of-1 trial design offers a methodologically sound approach to determining optimum treatment for an individual patient and solves some limitations of randomized controlled trials. This design could offer an efficient method of reaching a personal treatment regime tailored to suit individual needs and preferences. The paper introduces practical application, objects and the implementation process of N-of-1 trial, to explore its design points and implementation.
To standardize and improve the reporting quality of implementation studies, BMJ published the standards for reporting implementation studies (StaRI). This paper introduces the background and process of StaRI development, and interprets the core content of StaRI. It is expected that StaRI will provide support for domestic researchers to carry out implementation studies and writing implementation research reports.
Objective The ultimate goal of developing guidelines is for using them in clinical practice. In this study, an implementation evaluation tool was developed to promote the overall evaluation of guidelines and to improve their promotion and implementation. Methods The research group set up a team to formulate and establish a guideline implementation evaluation tool, through preliminary research, interviews, a systematic review of relevant literature, two expert consensus meetings and two Delphi expert consensus meetings to evaluate the guideline implementation tool. Experts were invited to give opinions and grades on the fields, items and overall implementation evaluation method of the tool. Results The evaluation tool for the implementation of guidelines included 5 fields, accessibility, communicability, performability, recognizability and applicability, with a total of 7 items. The scale-level CVIs in two rounds of Delphi expert consensus were 0.91 and 0.93. We collected opinions and suggestions and made some revisions and insertions without deleting any items based on the parameter that no items fulfilled the standard if mean <3.5, coefficient of variation >15% and I-CVI<0.78. Conclusion In this study, in order to provide a standard and method for the evaluation of guideline implementation, a guideline implementation evaluation tool has been developed and evaluated by clinically-related physicians and guideline formulation methodology experts. The guideline implementation evaluation tool presents satisfactory face and content validity. Empirical research is needed to verify the tool’s performance in evaluating guideline implementation.
Effectiveness-implementation hybrid designs can test the effectiveness of interventions and the outcomes of implementation strategies concurrently and accelerate the transformation of research results into routine practice. This paper introduced three types of effectiveness-implementation hybrid designs and corresponding reporting guidelines, including standards for reporting implementation studies, cluster randomized design and CONSORT 2010, stepped-wedge cluster randomized design and extended version CONSORT 2018, qualitative research and COREQ reporting guideline, and provide references for domestic researchers to produce research reports on effectiveness-implementation hybrid design.