Barriers and enablers for the implementation of clinical practice guidelines in China: a mixed-method study
Objectives The aim of this study was to explore perspectives and reasoning of medical staff from Class A tertiary hospitals about the factors hindering and facilitating the uptake and use of clinical practice guidelines (CPGs) during medical procedures.Design Mixed-method research study to collect a...
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BMJ Publishing Group
2019-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/9/e026328.full |
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| author | Fei Han Yinghui Jin Zimeng Li Di Huang Qiao Huang Yue Cao Hong Weng Xian-Tao Zeng Xinghuan Wang Hong-Cai Shang |
| author_facet | Fei Han Yinghui Jin Zimeng Li Di Huang Qiao Huang Yue Cao Hong Weng Xian-Tao Zeng Xinghuan Wang Hong-Cai Shang |
| author_sort | Fei Han |
| collection | DOAJ |
| description | Objectives The aim of this study was to explore perspectives and reasoning of medical staff from Class A tertiary hospitals about the factors hindering and facilitating the uptake and use of clinical practice guidelines (CPGs) during medical procedures.Design Mixed-method research study to collect and analyse both quantitative and qualitative data.Setting Class A tertiary hospitals in China.Participants The inclusion criteria for the questionnaire survey and qualitative research were (1) medical practitioners and (2) years of practice: above 5 years in a tertiary hospital.Methods Questionnaires were distributed to medical staff in 11 cities to collect quantitative data. Frequency and ranking of barriers and enablers were analysed. Spearman correlations were computed to explore the correlation between years of practice, professional title ranking and educational background with self-reported guideline adherence. Using a constructivist grounded theory method, qualitative data were generated via in-depth face-to-face interviews with Chinese medical practitioners.Results A total of 359 medical practitioners were surveyed and 32 medical practitioners interviewed in 11 cities. Higher frequency and higher ranking of barriers all converged on ‘lack of access’, ‘less convenient’, ‘lack of applicability’ and ‘lack of evidence from Chinese sample’. Higher frequency and higher ranking of enablers converged on ‘Short formats presentation’, ‘Utilisation of various media’, ‘Information visualisation’ and ‘Linking to patient electronic medical records’. There were no relationships between characteristics of respondents with self-reported adherence. This research produced a theoretical understanding of the experience of medical practitioners when using guidelines. Themes identified were as follows: existing intrinsic flaws in guidelines, deficient or incomplete system mechanism and being ambiguous.Conclusion Our findings provide a comprehensive and culturally sensitive perspective in understanding guideline implementation in China. Strategies addressing those barriers should be further discussed and researched in the future. |
| format | Article |
| id | doaj-art-2f1fc0f4417e4ec5b32a2da54690dba3 |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-2f1fc0f4417e4ec5b32a2da54690dba32025-08-20T02:50:26ZengBMJ Publishing GroupBMJ Open2044-60552019-09-019910.1136/bmjopen-2018-026328Barriers and enablers for the implementation of clinical practice guidelines in China: a mixed-method studyFei Han0Yinghui Jin1Zimeng Li2Di Huang3Qiao Huang4Yue Cao5Hong Weng6Xian-Tao Zeng7Xinghuan Wang8Hong-Cai Shang9Yangzhou Key Laboratory of Pancreatic Disease, Institute of Digestive Diseases, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China2 Center for Evidence-Based and Translational Medicine, wuhan daxue zhongnan yiyuan, Wuhan, Hubei, China2 Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaShandong University of Traditional Chinese Medicine, Jinan, Shandong, ChinaDepartment of Oncology, The First College of Clinical Medical Science, Yichang, Hubei, China1 Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China1 Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China1 Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China1 Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China4 Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, ChinaObjectives The aim of this study was to explore perspectives and reasoning of medical staff from Class A tertiary hospitals about the factors hindering and facilitating the uptake and use of clinical practice guidelines (CPGs) during medical procedures.Design Mixed-method research study to collect and analyse both quantitative and qualitative data.Setting Class A tertiary hospitals in China.Participants The inclusion criteria for the questionnaire survey and qualitative research were (1) medical practitioners and (2) years of practice: above 5 years in a tertiary hospital.Methods Questionnaires were distributed to medical staff in 11 cities to collect quantitative data. Frequency and ranking of barriers and enablers were analysed. Spearman correlations were computed to explore the correlation between years of practice, professional title ranking and educational background with self-reported guideline adherence. Using a constructivist grounded theory method, qualitative data were generated via in-depth face-to-face interviews with Chinese medical practitioners.Results A total of 359 medical practitioners were surveyed and 32 medical practitioners interviewed in 11 cities. Higher frequency and higher ranking of barriers all converged on ‘lack of access’, ‘less convenient’, ‘lack of applicability’ and ‘lack of evidence from Chinese sample’. Higher frequency and higher ranking of enablers converged on ‘Short formats presentation’, ‘Utilisation of various media’, ‘Information visualisation’ and ‘Linking to patient electronic medical records’. There were no relationships between characteristics of respondents with self-reported adherence. This research produced a theoretical understanding of the experience of medical practitioners when using guidelines. Themes identified were as follows: existing intrinsic flaws in guidelines, deficient or incomplete system mechanism and being ambiguous.Conclusion Our findings provide a comprehensive and culturally sensitive perspective in understanding guideline implementation in China. Strategies addressing those barriers should be further discussed and researched in the future.https://bmjopen.bmj.com/content/9/9/e026328.full |
| spellingShingle | Fei Han Yinghui Jin Zimeng Li Di Huang Qiao Huang Yue Cao Hong Weng Xian-Tao Zeng Xinghuan Wang Hong-Cai Shang Barriers and enablers for the implementation of clinical practice guidelines in China: a mixed-method study BMJ Open |
| title | Barriers and enablers for the implementation of clinical practice guidelines in China: a mixed-method study |
| title_full | Barriers and enablers for the implementation of clinical practice guidelines in China: a mixed-method study |
| title_fullStr | Barriers and enablers for the implementation of clinical practice guidelines in China: a mixed-method study |
| title_full_unstemmed | Barriers and enablers for the implementation of clinical practice guidelines in China: a mixed-method study |
| title_short | Barriers and enablers for the implementation of clinical practice guidelines in China: a mixed-method study |
| title_sort | barriers and enablers for the implementation of clinical practice guidelines in china a mixed method study |
| url | https://bmjopen.bmj.com/content/9/9/e026328.full |
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