Implementation of Project ECHO in a university health network: contrasting and comparing experiences across health conditions through a qualitative approach in a Canadian tertiary care centre.

Autor:	Develay É; Research Center, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada., Wartelle-Bladou C; Research Center, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada., Talbot A; Research Center, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.; Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Quebec, Canada., Khemiri R; Research Center, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada., Parent J; Research Center, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.; Réseau universitaire intégré de santé et de services sociaux de l'Université de Montréal (RUISSS de l'UdeM), Montreal, Quebec, Canada., Boulanger A; Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.; Department of Anesthesiology and Pain Medicine, Université de Montréal, Montreal, Quebec, Canada., Dubreucq S; Research Center, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.; Department of Psychiatry, Université de Montréal, Montreal, Quebec, Canada., Pagé MG; Research Center, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada gabrielle.page@umontreal.ca.; Department of Anesthesiology and Pain Medicine, Université de Montréal, Montreal, Quebec, Canada.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2024 Sep 17; Vol. 14 (9), pp. e082947. Date of Electronic Publication: 2024 Sep 17.
DOI:	10.1136/bmjopen-2023-082947
Abstrakt:	Objectives: The objective of this study was to compare and contrast the experiences of interdisciplinary attendees (spokes) and experts (hub members) from three Extension for Community Healthcare Outcomes (ECHO) programmes: hepatitis C, chronic pain and concurrent mental health and substance use disorders. Design: Prospective qualitative study. Setting: Single-centre in tertiary care. Participants: The team conducted 30 one-on-one interviews with spokes and 4 focus groups with hub members from three ECHO programmes. Analyses: Three analysts were involved to perform a reflexive thematic analysis. Results: Our results showed the benefits and limitations of the three ECHOs, varying according to specificities of targeted chronic conditions. Three overarching themes were identified from the data analysis: (1) perceived impacts of an interprofessional educational setting; (2) nature of disease and interprofessional interactions as determinants of clinical practice changes in diagnoses and treatments and (3) impacts on patient engagement and care pathways. Conclusions: The extent to which a chronic disease relies on a biopsychosocial approach, the degree of interdisciplinary care required and the simplicity/complexity of treatment algorithms influence perceived benefits and barriers to participating in ECHO programmes. These points raised by our study are important in the understanding of the successes and limitations of implementing an ECHO programme. They are essential as they provide key information for tailoring Project ECHO to the chronic disease it addresses. Competing Interests: Competing interests: GP received honoraria from Canopy Growth and research grant from Pfizer Canada for work unrelated to the present study. AT has a family member working for ViiV USA, a pharmaceutical company. Other members have no competing interest to declare. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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