Linda S Franck1, Rebecca M Kriz2, Seema Rego3, Karen Garman3, Charlotte Hobbs4, David Dimmock4. 1. Department of Family Health Care Nursing, University of California San Francisco, San Francisco, CA. Electronic address: linda.franck@ucsf.edu. 2. Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA. 3. Rady Children's Institute for Genomic Medicine, San Diego, CA. 4. Rady Children's Institute for Genomic Medicine, San Diego, CA; Rady Children's Hospital, San Diego, CA.
Abstract
OBJECTIVE: To characterize the views of members of the multi-disciplinary team regarding the implementation of Rapid Whole Genome Sequencing (rWGS) as a first-tier test for critically ill children in diverse children's hospital settings. STUDY DESIGN: Qualitative interviews informed by implementation science theory were conducted with the multi-disciplinary patient care teams and hospital leaders at each of the five tertiary care children's hospitals involved in a statewide rWGS implementation project. RESULTS: Our analysis revealed 5 key themes regarding the implementation process across the sites: the need for rWGS champions, educational needs and strategies, negotiating decision-making roles and processes, workflows and workarounds, and perceptions about rWGS. From the findings a composite clinical workflow diagram was developed to summarize all of the processes involved in the implementation of the test, and the key areas where implementation practices differed. CONCLUSIONS: These findings provide insights for design of interventions to support adoption, scale-up and sustainability of rWGS and other novel technologies in neonatal and pediatric critical care settings.
OBJECTIVE: To characterize the views of members of the multi-disciplinary team regarding the implementation of Rapid Whole Genome Sequencing (rWGS) as a first-tier test for critically illchildren in diverse children's hospital settings. STUDY DESIGN: Qualitative interviews informed by implementation science theory were conducted with the multi-disciplinary patient care teams and hospital leaders at each of the five tertiary care children's hospitals involved in a statewide rWGS implementation project. RESULTS: Our analysis revealed 5 key themes regarding the implementation process across the sites: the need for rWGS champions, educational needs and strategies, negotiating decision-making roles and processes, workflows and workarounds, and perceptions about rWGS. From the findings a composite clinical workflow diagram was developed to summarize all of the processes involved in the implementation of the test, and the key areas where implementation practices differed. CONCLUSIONS: These findings provide insights for design of interventions to support adoption, scale-up and sustainability of rWGS and other novel technologies in neonatal and pediatric critical care settings.
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Authors: Linda S Franck; Andrea Scheurer-Monaghan; Caleb P Bupp; Joseph D Fakhoury; Thomas J Hoffmann; Manasi Deshpandey; Madison Arenchild; David P Dimmock Journal: Children (Basel) Date: 2022-03-04