Assessing multilevel determinants of adoption and implementation of genomic medicine: an organizational mixed-methods approach

作者：Oishi Sabine M^*; Marshall Nell; Hamilton Alison B; Yano Elizabeth M; Lerner Barbara; Scheuner Maren T

来源：Genetics in Medicine, 2015, 17(11): 919-926.

DOI：10.1038/gim.2015.7

• genomic medicine
• health services
• implementation
• organization
• translation

Purpose: Adoption and implementation of evidence-based genetic and genomic medicine have been slow. We describe a methodology for identifying the influence of organizational factors on adoption and implementation of these services in health-care organizations.
Methods: We illustrate a three-component, mixed-methods health services research approach, including expert panels, qualitative interviews with key informants, and quantitative surveys completed by key informants.
Results: This research approach yielded a baseline assessment of existing genetic health-care models in the Veterans Health Administration and identified organizational barriers to and facilitators of adoption. In aggregate, the panel and key informant strategies created a communication network of relevant organizational stakeholders and a detailed foundation of organizational knowledge from which to design tools and models for implementation-level genetic/genomic translation.
Conclusion: Expert panel and key informant strategies can be used to create a backdrop of stakeholder involvement and baseline organizational knowledge within which to plan translation research and to inform strategic planning and policies for adoption and implementation of genetic services in health-care organizations.

• 出版日期2015-11