研究一种工作系统的方法来实施急诊科浪涌管理系统卡塔尔世界杯8强波胆分析案例研究%A Jewer,Jennifer %+纽芬兰纪念大学工商管理学院，300 Prince Philip Drive, St. John, NL, A1B 3X5, Canada, 1 7098643094, jenniferj@mun.ca %K急诊科%K激增管理%K工作系统%K系统实施%K急诊科信息系统%K手机%D 2022 %7 25.8.2022 %9原论文%J J Med Internet Res %G English %X背景:急诊科(ED)拥挤是一个全球性的卫生保健问题。电子卫生系统有可能减少拥挤;然而，真正的好处很少实现，因为系统没有集成到临床医生的工作。我们希望深入了解如何构建电子健康系统，以便将系统真正集成到工作流程中。目的:本研究的具体目的是检验工作系统理论(WST)是否是一种很好的方法，通过将整个工作系统，而不仅仅是电子卫生系统，纳入实施框架;确定WST的静态框架和动态工作系统生命周期模型的具体元素在实施中所起的作用;并演示如何将WST应用于卫生保健环境，以指导电子卫生系统的实施。方法:通过一个农村医院急诊科的案例研究，我们采用混合方法的方法，通过WST的视角来检查激增管理系统的实施。我们在急诊室进行了14小时的观察; 20 interviews with clinicians, management, and members of the implementation team; and a survey of 23 clinicians; reviewed related documentation; and analyzed ED data to measure wait times. We used template analysis based on WST to structure our analysis of qualitative data and descriptive statistics for quantitative data. Results: The surge management system helped to reduce crowding in the ED, staff was satisfied with the implementation, and wait time improvements have been maintained for several years. Although study participants indicated changes to their workflow, 72% (13/18) of survey participants were satisfied with their use of the system, and 82% (14/17) indicated that it was integrated with their workflow. Examining the implementation through the lens of WST enabled us to identify the aspects of the implementation that made it so successful. By applying the WST static framework, we saw how the implementation team incorporated the elements of the ED work system, assessed their alignment, and designed interventions to address areas of misalignment. The dynamic work system life cycle model captured how planned and unplanned changes were managed throughout the iterative implementation cycle—83% (15/18) of participants indicated that there was sufficient management support for the changes and 80% (16/20) indicated the change served an important purpose. Conclusions: The broad scope and holistic approach of WST is well suited to guide eHealth system implementations as it focuses efforts on the entire work system and not just the IT artifact. We broaden the focus of WST by applying it to the implementation of an ED surge management system. These findings will guide further studies and implementations of eHealth systems using WST. %M 36006684 %R 10.2196/37472 %U //www.mybigtv.com/2022/8/e37472 %U https://doi.org/10.2196/37472 %U http://www.ncbi.nlm.nih.gov/pubmed/36006684