Emergency Medical Services Leadership Perspectives on Implementation of Evidence-Based Guidelines: A Qualitative Study

作者：Christina Guerrier, Jennifer Brailsford, Shama Patel, Shannon Burcham, Ramzi George Salloum, Christian Martin‐Gill, Christopher T. Richards, Ashish R. Panchal, Jennifer Noel Fishe · 发表于：Prehospital Emergency Care · 年份：2022 · DOI：10.1080/10903127.2022.2128484 · 被引用次数：14 · 研究领域：Health Policy Implementation Science、Health Sciences Research and Education、Nursing Roles and Practices

Introduction: Prehospital evidence-based guidelines (EBGs) are developed to optimize clinical outcomes for emergency medical services (EMS) patients. However, widespread implementation of EBGs is often inconsistent. Therefore, this study aimed to assess the baseline knowledge and practices of EMS leaders related to EBG implementation.Methods: This was a qualitative study using focus groups to assess prehospital implementation awareness and knowledge. Participants were EMS EBG authors, EMS medical directors, and EMS professional organization leaders. Focus groups were held via video conference, audio recorded, and transcribed. Thematic coding used domains and constructs of the Consolidated Framework for Implementation Research (CFIR).Results: Six focus groups were conducted with a total of 18 participants. A total of 1,044 codes were analyzed. “Process” was the CFIR domain with the most codes (n = 350, 33.5%), followed by the “inner setting” (the EMS agency; n = 250, 23.9%), “characteristics of the intervention” (n = 203, 19.4%), “outer setting” (the health care system and community the EMS agency serves, and the broader national EMS professional context; n = 141, 13.5%), and “characteristics of individuals” (n = 100, 9.6%). The ten most frequent constructs across all domains were: reflecting and evaluating, executing, cosmopolitanism, planning, external policy and incentives, design quality and packaging, learning climate, culture, complexity, and other personal attributes.Co...