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Dual equipoise shared decision making: definitions for decision and behaviour support interventionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
DiscussionPreference-sensitive decisions are defined by equipoise: situations where options need to be deliberated. Moreover, where both healthcare professionals and patients agree that equipoise exists, situations may be regarded as having 'dual equipoise'. Such conditions are ideal for shared decision making. However, there are many situations in medicine where dual equipoise does not exist, where health professionals hold the view that scientific evidence for benefit strongly outweighs harm. This is often the case where people suffer from chronic conditions, and where behaviour change is recommended to improve outcomes....
Source: Implementation Science - November 18, 2009 Category: Health Management Authors: Glyn ElwynDominick FroschStephen Rollnick Source Type: journals

Exploring the black box of quality improvement collaboratives: modelling relations between conditions, applied changes and outcomesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The objective of the current study is to learn more about relations between relevant conditions for successful implementation of QICs, applied changes, perceived successes, and actual outcomes. Methods: Twenty-four Dutch hospitals participated in a dissemination programme based on QICs. A questionnaire was sent to 237 leaders of teams who joined 18 different QICs to measure changes in working methods and activities, overall perceived success, team organisation, and supportive conditions. Actual outcomes were extracted from a database with team performance indicator data. Multi-level analyses were conducted to test a number...
Source: Implementation Science - November 17, 2009 Category: Health Management Authors: Michel DuckersPeter SpreeuwenbergCordula WagnerPeter Groenewegen Source Type: journals

Adjuncts or adversaries to shared decision-making? Applying the Integrative Model of behavior to the role and design of decision support interventions in healthcare interactionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We describe how Fishbein's Integrative Model (IM) of behavior can be applied to the development and evaluation of DESIs. There are several ways in which the IM could be used in research on the behavioral effects of DESIs. An investigator could measure the effects of an intervention on the central constructs of the IM - attitudes, normative pressure, self-efficacy, and intentions related to communication behaviors relevant to shared decision-making. However, if one were interested in the determinants of these domains, formative qualitative research would be necessary to elicit the salient beliefs underlying each of the cent...
Source: Implementation Science - November 12, 2009 Category: Health Management Authors: Dominick FroschFrance LegareMartin FishbeinGlyn Elwyn Source Type: journals

The National Institute of Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Leicestershire, Northamptonshire and Rutland (LNR): a programme protocolEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
DiscussionThis paper describes one of the nine Collaborations, that of Leicestershire, Northamptonshire and Rutland. Drawing a distinction between translation as an organising principle for health care providers and implementation as a discrete activity, this Collaboration is built on a substantial programme of applied research intended to create both research generation and research use capacity in provider organisations. The Collaboration in Leicestershire, Northamptonshire and Rutland has potential to provide evidence on how partnerships between practitioners, patients and researchers can improve the transfer of evidenc...
Source: Implementation Science - November 12, 2009 Category: Health Management Authors: Richard BakerNoelle RobertsonStephen RogersMelanie DaviesNigel BrunskillKamlesh KhuntiMichael SteinerMartin WilliamsPaul Sinfield Source Type: journals

The effect of provider- and workflow-focused strategies for guideline implementation on provider acceptanceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Provider acceptance of CPGs depends on the type of implementation strategies used. Implementation effectiveness can be improved by using both workflow-focused as well as provider-focused strategies. (Source: Implementation Science)
Source: Implementation Science - October 29, 2009 Category: Health Management Authors: Mindy FlanaganRangaraj RamanujamBradley Doebbeling Source Type: journals

Using theories of behaviour to understand transfusion prescribing in three clinical contexts in two countries: development work for an implementation trialEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background: Blood transfusion is an essential part of healthcare and can improve patient outcomes. However, like most therapies, it is also associated with significant clinical risks. In addition, there is some evidence of over-use. Understanding the potential barriers and enablers to reduced prescribing of blood products will facilitate the selection of intervention components likely to be effective, thereby reducing the number of costly trials evaluating different implementation strategies. Using a theoretical basis to understand behaviours targeted for change will contribute to a "basic science" relating to determinants...
Source: Implementation Science - October 23, 2009 Category: Health Management Authors: Jill FrancisAlan TinmouthSimon StanworthJeremy GrimshawMarie JohnstonChris HydeCharlotte StocktonJamie BrehautDean FergussonMartin Eccles Source Type: journals

Implementation research design: integrating participatory action research into randomized controlled trialsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
DiscussionWe summarize key elements of participatory action research, with particular attention to its collaborative, reflective approach. Elements of participatory action research and randomized controlled trial study designs are discussed and contrasted, with a complex adaptive systems approach used to frame their integration.SummaryThe integration of participatory action research and randomized controlled trial design results in a new approach that reflects not only the complex nature of healthcare organizations, but also the need to obtain generalizeable knowledge regarding the implementation process. (Source: Implementation Science)
Source: Implementation Science - October 22, 2009 Category: Health Management Authors: Luci LeykumJacqueline PughHolly LanhamJoel HarmonReuben McDaniel Source Type: journals

Effectiveness of strategies to encourage general practitioners to accept an offer of free access to online evidence-based information: a randomised controlled trialEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: This study showed low acceptance rates of the offer of access to the on-line resource when there was an associated requirement of response to a short on-line questionnaire and non-obtrusive monitoring of GP behaviour in terms of accessing the resource. If we are to improve care and encourage evidence based practice we need to find effective ways of motivating doctors and other health professionals to take part in research that can inform our implementation efforts. (Source: Implementation Science)
Source: Implementation Science - October 19, 2009 Category: Health Management Authors: Heather BuchanEmma LoureyCaterine D'EsteRob Sanson-Fisher Source Type: journals

A theory of organizational readiness for changeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
DiscussionOrganizational readiness for change is a multi-level, multi-faceted construct. As an organization-level construct, readiness for change refers to organizational members' shared resolve to implement a change (change commitment) and shared belief in their collective capability to do so (change efficacy). Organizational readiness for change varies as a function of how much organizational value the change and how favorably they appraise three key determinants of implementation capability: task demands, resource availability, and situational factors. When organizational readiness for change is high, organizational mem...
Source: Implementation Science - October 18, 2009 Category: Health Management Authors: Bryan Weiner Source Type: journals

Barriers and supports to implementation of MDI/spacer use in nine Canadian pediatric emergency departments: a qualitative studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Potential barriers and supports to implementation have been identified that will help EDs adopt MDI/spacer use. Future interventions intended to increase MDI/spacer use in PEDs will need to be sensitive to the barriers identified in this study. (Source: Implementation Science)
Source: Implementation Science - October 12, 2009 Category: Health Management Authors: Shannon ScottMartin OsmondKathy O'LearyIan GrahamJeremy GrimshawTerry KlassenPediatric Emergency Research Canada MDI/spacer Study Group Perc Source Type: journals

An exploration of how clinician attitudes and beliefs influence the implementation of lifestyle risk factor management in primary healthcare: a grounded theory studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The model extends previous research by outlining a process by which clinicians' perceptions shape implementation of lifestyle risk factor management in routine practice. This provides new insights to inform the development of effective strategies to improve such practices. (Source: Implementation Science)
Source: Implementation Science - October 12, 2009 Category: Health Management Authors: Rachel LawsLynn KempMark HarrisGawaine Powell DaviesAnna WilliamsRosslyn Eames-Brown Source Type: journals

A social marketing approach to implementing evidence-based practice in VHA QUERI: the TIDES depression collaborative care modelEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Discussion and conclusionDevelopment, execution and evaluation of the TIDES marketing effort shows that social marketing is a promising approach for promoting implementation of evidence-based interventions in integrated healthcare systems. (Source: Implementation Science)
Source: Implementation Science - September 28, 2009 Category: Health Management Authors: Jeff LuckF HagigiLouise ParkerElizabeth YanoLisa RubensteinJoAnn Kirchner Source Type: journals

A randomized controlled trial evaluating the impact of knowledge translation and exchange strategiesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background: Significant resources and time are invested in the production of research knowledge. The primary objective of this randomized controlled trial was to evaluate the effectiveness of three knowledge translation and exchange strategies in the incorporation of research evidence into public health policies and programs. Methods: This trial was conducted with a national sample of public health departments in Canada from 2004 to 2006. The three interventions, implemented over one year in 2005, included access to an online registry of research evidence; tailored messaging; and a knowledge broker. The primary outcome ass...
Source: Implementation Science - September 22, 2009 Category: Health Management Authors: Maureen DobbinsSteven HannaDonna CiliskaSteve ManskeRoy CameronShawna MercerLinda O'MaraKara DeCorbyPaula Robeson Source Type: journals

Improving outcomes for ill and injured children in emergency departments: protocol for a program in pediatric emergency medicine and knowledge translation scienceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Approximately one quarter of all Canadian children will seek emergency care in any given year, with the two most common medical problems affecting children in the ED being acute respiratory illness and injury. Treatment for some medical conditions in the ED remains controversial due to a lack of strong supporting evidence.The purpose of this paper is to describe a multi-centre Team Grant in Pediatric Emergency Medicine (PEM) that has been recently funded by the Canadian Institutes of Health Research (CIHR). This program of research integrates clinical research (in the areas of acute respiratory illness and injury) and know...
Source: Implementation Science - September 21, 2009 Category: Health Management Authors: Shannon ScottLisa HartlingJeremy GrimshawDavid JohnsonMartin OsmondAmy PlintRollin BrantJamie BrehautIan GrahamGillian CurrieNicola ShawMaala BhattTim LynchLiza BialyTerry Klassen Source Type: journals

Curricula for teaching the content of clinical practice guidelines to family medicine and internal medicine residents in the US: a survey studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Residency programs teach different aspects of CPGs to varying degrees, and the majority uses educational strategies not supported by research evidence. (Source: Implementation Science)
Source: Implementation Science - September 20, 2009 Category: Health Management Authors: Elie AklReem MustafaMark WilsonAndrew SymonsAmir MoheetThomas RosenthalGordon GuyattHolger Schunemann Source Type: journals

'Experience talks': physician prioritisation of contrasting interventions to optimise management of acute cough in general practiceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: There are differences in attitudes to prioritising contrasting interventions for optimising LRTI management among GPs with and without experience of using the interventions, although GPs in both groups recognised the importance of both approaches to optimise management of acute cough. GPs' experiences with and attitudes towards interventions need to be taken into account when planning rollout of interventions aimed at changing clinical practice. (Source: Implementation Science)
Source: Implementation Science - September 7, 2009 Category: Health Management Authors: Jochen CalsChristopher ButlerGeert-Jan Dinant Source Type: journals

Study protocol for a group randomized controlled trial of a classroom-based intervention aimed at preventing early risk factors for drug abuse: integrating effectiveness and implementation researchEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study was designed to support two purposes. The first purpose was to test the effectiveness of a universal classroom-based intervention, the Whole Day First Grade Program (WD), aimed at two early antecedents of drug abuse and other problem behaviors, namely aggressive, disruptive behavior and poor academic achievement. The second purpose was to examine the utility of a multilevel structure to support high levels of implementation during the effectiveness trial, to sustain WD practices across additional years, and to train additional teachers in WD practices. Methods: The WD intervention integrated three components, ea...
Source: Implementation Science - September 1, 2009 Category: Health Management Authors: Jeanne PoduskaSheppard KellamC. Hendricks BrownCarla FordAmy WindhamNatalie KeeganWei Wang Source Type: journals

Exploring mentorship as a strategy to build capacity for knowledge translation research and practice: protocol for a qualitative studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
DiscussionThese findings could be used by universities, research institutes, funding agencies and professional organizations in Canada and elsewhere to develop, implement and evaluate mentorship for KT research and practice. This research will establish a theoretical basis upon which we and others can compare the cost-effectiveness of interventions that enhance KT mentorship. If successful this program of research may increase knowledge about, confidence in, and greater utilization of KT processes, and the quality and quantity of KT research, perhaps ultimately leading to better implementation and adoption of recommended h...
Source: Implementation Science - August 18, 2009 Category: Health Management Authors: Anna GagliardiLaure PerrierFiona WebsterKaren LeslieMary BellWendy LevinsonOri RotsteinAnn TourangeauLaurie MorrisonIvan SilverSharon Straus Source Type: journals

Study protocol for the translating research in elder care (TREC): building context - an organizational monitoring program in long-term care project (project 1)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study protocol describes the details of a multi-level -- including provinces, regions, facilities, units within facilities, and individuals who receive care (residents) or work (staff) in facilities -- and longitudinal (five-year) research project. A stratified random sample of 36 residential long-term care facilities (30 urban and 6 rural) from the Canadian Prairie Provinces will comprise the sample. Caregivers and care managers within these facilities will be asked to complete the TREC survey -- a suite of survey instruments designed to assess organizational context and related factors hypothesized to be important t...
Source: Implementation Science - August 10, 2009 Category: Health Management Authors: Carole EstabrooksJanet SquiresGreta CummingsGary TearePeter Norton Source Type: journals

Study protocol for the translating research in elder care (TREC): building context through case studies in long-term care project (project 2)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background: The organizational context in which healthcare is delivered is thought to play an important role in mediating the use of knowledge in practice. Additionally, a number of potentially modifiable contextual factors have been shown to make an organizational context more amenable to change. However, understanding of how these factors operate to influence organizational context and knowledge use remains limited. In particular, research to understand knowledge translation in the long-term care setting is scarce. Further research is therefore required to provide robust explanations of the characteristics of organizatio...
Source: Implementation Science - August 10, 2009 Category: Health Management Authors: Jo Rycroft-MaloneSue DopsonLesley DegnerAlison HutchinsonDebra MorganNorma StewartCarole Estabrooks Source Type: journals

Translating research in elder care: an introduction to a study protocol seriesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background: The knowledge translation field is undermined by two interrelated gaps -- underdevelopment of the science and limited use of research in health services and health systems decision making. The importance of context in theory development and successful translation of knowledge has been identified in past research. Additionally, examination of knowledge translation in the long-term care (LTC) sector has been seriously neglected, despite the fact that aging is increasingly identified as a priority area in health and health services research.AimsThe aims of this study are: to build knowledge translation theory abou...
Source: Implementation Science - August 9, 2009 Category: Health Management Authors: Carole EstabrooksAlison HutchinsonJanet SquiresJudy BirdsellGreta CummingsLesley DegnerDebra MorganPeter Norton Source Type: journals

Twelve years of clinical practice guideline development, dissemination and evaluation in Canada (1994 to 2005)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Given that guideline development processes have improved in some areas over the past 12 years yet not in others, ongoing monitoring of guideline quality is required. Guidelines produced more recently in Canada are less likely to be based on a review of the evidence and only about half discuss levels of evidence underlying recommendations. Guideline dissemination and implementation activities have actually decreased. Unfortunately, the potential positive impact on patient health outcomes will not be realized until the recommendations are adopted and acted upon. (Source: Implementation Science)
Source: Implementation Science - August 4, 2009 Category: Health Management Authors: Jennifer KryworuchkoDawn StaceyNan BaiIan Graham Source Type: journals

A method for studying decision-making by guideline development groupsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: This method is currently being applied to study the meetings of three of NICE GDGs. These cover topics in acute physical health, mental health and public health, and comprise a total of 45 full-day meetings. The method offers potential for application to other health care and decision-making groups. (Source: Implementation Science)
Source: Implementation Science - August 4, 2009 Category: Health Management Authors: Benjamin GardnerRosemary DavidsonJohn McAteerSusan MichieThe 'Evidence into Recommendations' Study Group Source Type: journals

Municipal policies and plans of action aiming to promote physical activity and healthy eating habits among schoolchildren in Stockholm, Sweden: a cross-sectional studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Policy documents and plans of action aiming to promote physical activity and healthy eating habits among schoolchildren aged six to 16 in municipalities and town districts in Stockholm County did not seem to have an impact on the local level of measures. Demographic and socio-economic characteristics of the municipalities and town districts were on the other hand associated with local health-promoting measures. (Source: Implementation Science)
Source: Implementation Science - August 2, 2009 Category: Health Management Authors: Karin GuldbrandssonKarin Modig WennerstadFinn Rasmussen Source Type: journals

An intervention to improve paediatric and newborn care in Kenyan district hospitals: Understanding the contextEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The effectiveness of interventions delivered at hospital level over periods realistically required to achieve change may be influenced by a wide variety of factors at national and local levels. We have demonstrated how dynamic such contexts are, and therefore the need to consider context when interpreting an intervention's effectiveness. (Source: Implementation Science)
Source: Implementation Science - July 22, 2009 Category: Health Management Authors: Mike EnglishStephen NtoburiJohn WagaiPatrick MbindyoNewton OpiyoPhilip AyiekoCharles OpondoSantau MigiroAnnah WamaeGrace Irimu Source Type: journals

Contextual influences on health worker motivation in district hospitals in KenyaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Motivation is likely to influence powerfully any attempts to change or improve health worker and hospital practices. Some factors influencing motivation may themselves be influenced by the processes chosen to implement change. (Source: Implementation Science)
Source: Implementation Science - July 22, 2009 Category: Health Management Authors: Patrick MbindyoDuane BlaauwLucy GilsonMike English Source Type: journals

Documenting the experiences of health workers expected to implement guidelines during an intervention study in Kenyan hospitalsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: While the barriers identified are broadly similar in theme to those reported from high-income settings, their specific nature often differs. For example, at an institutional level there is an almost complete lack of systems to introduce or reinforce guidelines, poor teamwork across different cadres of health worker, and failure to confront poor practice. At an individual level, lack of interest in the evidence supporting guidelines, feelings that they erode professionalism, and expectations that people should be paid to change practice threaten successful implementation. (Source: Implementation Science)
Source: Implementation Science - July 22, 2009 Category: Health Management Authors: Jacinta NzingaPatrick MbindyoLairumbi MbaabuAnn WariraMike English Source Type: journals

Implementation experience during an eighteen month intervention to improve paediatric and newborn care in Kenyan district hospitalsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The actual content of an intervention and how it is implemented and received may be critical determinants of whether it achieves its aims. We have carefully described our intervention approach to facilitate appraisal of the quantitative results of the intervention's effect on quality of care. Our findings suggest ongoing training, external supportive supervision, open feedback, and local facilitation may be valuable additions to more typical in-service training approaches, and may be feasible. (Source: Implementation Science)
Source: Implementation Science - July 22, 2009 Category: Health Management Authors: Jacinta NzingaStephen NtoburiJohn WagaiPatrick MbindyoLairumbi MbaabuSantau MigiroAnnah WamaeGrace IrimuMike English Source Type: journals

Is research working for you? Validating a tool to examine the capacity of health organizations to use researchEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The tool can serve as a catalyst for an important discussion about research use at the organizational level; such a discussion, in and of itself, demonstrates potential as an intervention to encourage processes and supports for research translation. (Source: Implementation Science)
Source: Implementation Science - July 22, 2009 Category: Health Management Authors: Anita KothariNancy EdwardsNadia HamelMaria Judd Source Type: journals

Barriers and facilitators to evidence based care of type 2 diabetes patients: experiences of general practitioners participating to a quality improvement programEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Qualitative research nested in an experimental trial may clarify the improvements that a QIP may bring about in a general practice, provide insight into GPs' approach to diabetes care and reveal the program's limits. Implementation of a QIP encounters an array of cognitive, motivational and relational obstacles that are embedded in a patient-health care provider relationship. (Source: Implementation Science)
Source: Implementation Science - July 21, 2009 Category: Health Management Authors: Geert GoderisLiesbeth BorgermansChantal MathieuCarine Van Den BroekeKaren HannesJan HeyrmanRichard Grol Source Type: journals

Specifying and reporting complex behaviour change interventions: the need for a scientific methodEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Complex behaviour change interventions are not well described; when they are described, the terminology used is inconsistent. This constrains scientific replication, and limits the subsequent introduction of successful interventions. Implementation Science is introducing a policy of initially encouraging and subsequently requiring the scientific reporting of complex behaviour change interventions. (Source: Implementation Science)
Source: Implementation Science - July 15, 2009 Category: Health Management Authors: Susan MichieDean FixsenJeremy GrimshawMartin Eccles Source Type: journals

Organizational readiness to change assessment (ORCA): Development of an instrument based on the Promoting Action on Research in Health Services (PARiHS) frameworkEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: We find general support for the reliability and factor structure of the ORCA. Discrepant results included poor reliability among measures of evidence, and factor analysis results for measures of general resources and clinical champion role did not conform to the PARIHS framework. Additional validation is needed, including criterion validation. (Source: Implementation Science)
Source: Implementation Science - July 13, 2009 Category: Health Management Authors: Christian HelfrichYu-Fang LiNancy SharpAnne Sales Source Type: journals

The QICKD study protocol: a cluster randomised trial to compare quality improvement interventions to lower systolic BP in chronic kidney disease (CKD) in primary careEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study aims to test whether quality improvement interventions improve primary care management of elevated BP in CKD, reduce cardiovascular risk, and slow renal disease progressionDesignCluster randomised controlled trial (CRT) Methods: This three-armed CRT compares two well-established quality improvement interventions with usual practice. The two interventions comprise: provision of clinical practice guidelines with prompts and audit-based education.The study population will be all individuals with CKD from general practices in eight localities across England. Randomisation will take place at the level of the general ...
Source: Implementation Science - July 13, 2009 Category: Health Management Authors: Simon de LusignanHugh GallagherTom ChanNicki ThomasJeremy van VlymenMichael NationNeerja JainAumran TahirElizabeth du BoisIain CrinsonNigel HagueFiona ReidKevin Harris Source Type: journals

Are there valid proxy measures of clinical behaviour? a systematic reviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Valid measures of clinical behaviour are of fundamental importance to accurately identify gaps in care delivery, improve quality of care, and ultimately to improve patient care. However, the evidence base for three commonly used proxy measures of clinicians' behaviour is very limited. Further research is needed to better establish the methods of development, application, and analysis for a range of both direct and proxy measures of behaviour. (Source: Implementation Science)
Source: Implementation Science - July 2, 2009 Category: Health Management Authors: Susan HrisosMartin EcclesJill FrancisHeather DickinsonEileen KanerFiona BeyerMarie Johnston Source Type: journals

An exploration of how guideline developer capacity and guideline actionability influence implementation and adoption: study protocolEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
DiscussionPrevious research examined guideline implementation by measuring rates of compliance with recommendations or associated outcomes but this produced little insight on how the products themselves, or their implementation could be improved. This research will establish a theoretical basis upon which to conduct experimental studies to compare the cost-effectiveness of interventions that enhance guideline development and implementation capacity. Such studies could first examine short-term outcomes predictive of guideline utilization such as recall, attitude to, confidence in, and adoption intention. If successful, then...
Source: Implementation Science - July 1, 2009 Category: Health Management Authors: Anna GagliardiMelissa BrouwersValerie PaldaLouise Lemieux-CharlesJeremy Grimshaw Source Type: journals

Riding the knowledge translation roundabout: lessons learned from the Canadian Institutes of Health Research Summer Institute in knowledge translationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: National and international KT organizations, research institutions, and funding agencies are encouraged to consider replicating the training model employed here, as investment into KT personnel will foster the advancement of the field within and beyond local borders.'To the individual who devotes his/her life to science, nothing can give more happiness than when the results immediately find practical application. There are not two sciences. There is science and the application of science, and these two are linked as the fruit is to the tree.' – Louis Pasteur, 1871 (from presentation by Ian Graham, 2008 CIHR K...
Source: Implementation Science - June 11, 2009 Category: Health Management Authors: Michelle KhoElizabeth EsteyRyan DeForgeLeanne MakBrandi Bell Source Type: journals

Development of a minimization instrument for allocation of a hospital-level performance improvement intervention to reduce waiting times in Ontario Emergency DepartmentsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: We developed a simple tool designed to gather data from senior hospital administrators on factors likely to affect the success of a hospital patient flow improvement intervention. A minimization algorithm will ensure balanced allocation of the intervention with respect to these factors in study hospitals. (Source: Implementation Science)
Source: Implementation Science - June 8, 2009 Category: Health Management Authors: Chad LeaverAstrid GuttmannMerrick ZwarensteinBrian RoweGeoff AndersonTherese StukelBrian GoldenRobert BellDante MorraHoward AbramsMichael Schull Source Type: journals

Can't do it, won't do it! Developing a theoretically framed intervention to encourage better decontamination practice in Scottish dental practicesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Considerable resources are devoted to encouraging clinicians to implement evidence-based practice using interventions with erratic success records, or no known applicability to a specific clinical behaviour, selected mainly by means of researchers' intuition or optimism. The methodology used to develop this implementation intervention is not limited to decontamination nor to a single segment of primary care. It also accords with the preliminary stages of the framework for evaluating complex interventions suggested by the medical research council. The next phases of this work are to test the intervention feasib...
Source: Implementation Science - June 5, 2009 Category: Health Management Authors: Debbie BonettiLinda YoungIrene BlackHeather CassieCraig RamsayJan Clarkson Source Type: journals

A knowledge synthesis of patient and public involvement in clinical practice guidelines: study protocolEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study aims at identifying what it is about PPIP that works, in which contexts are PPIP most likely to be effective, and how are PPIP assumed to lead to better CPGs development and implementation. Methods: A knowledge synthesis will be conducted in four phases. In phase one, literature on PPIP in CPGs development will be searched through bibliographic databases. A call for bibliographic references and unpublished reports will also be sent via the mailing lists of relevant organizations. Eligible publications will include original qualitative, quantitative, or mixed methods study designs reporting on a PPIP pertaining t...
Source: Implementation Science - June 4, 2009 Category: Health Management Authors: France LegareAntoine BoivinTrudy van der WeijdenChristine PackenhamSylvie TappJako Burgers Source Type: journals

Development of a theory of implementation and integration: Normalization Process TheoryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Normalization Process Theory has been developed through procedures that were properly sceptical and critical, and which were opened to review at each stage of development. The theory has been shown to be sufficiently robust to merit formal testing. (Source: Implementation Science)
Source: Implementation Science - May 21, 2009 Category: Health Management Authors: Carl MayFrances MairTracy FinchAnne MacFarlaneChristopher DowrickShaun TreweekTim RapleyLuciana BalliniBie Nio OngAnne RogersElizabeth MurrayGlyn ElwynFrance LegareJane GunnVictor Montori Source Type: journals

Use of communities of practice in business and health care sectors: A systematic reviewEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: There is no dominant trend in how the CoP concept is operationalized in the business and health sectors; hence it is challenging to define the parameters of CoP groups. This may be one of the reasons for the lack of studies on the effectiveness of CoPs in the health sector. In order to improve the usefulness of the CoP concept in the development of groups and teams, further research will be needed to clarify the extent to which the four characteristics of CoPs are present in the mature and emergent groups, the expectations of facilitators and other participants, and the power relationship within CoPs. (Source:...
Source: Implementation Science - May 17, 2009 Category: Health Management Authors: Linda C Li, Jeremy M Grimshaw, Camilla Nielsen, Maria Judd, Peter C Coyte and Ian D Graham Source Type: journals

Evolving the theory and praxis of knowledge translation through social interaction: a social phenomenological studyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Study findings suggest the relevance of principles and foci from the field of process evaluation related to intervention implementation, further illuminating KT as a structuration process facilitated by evolving transformative leadership in an active and integrated context. The model provides guidance for proactively constructing a 'fit' between content, context, and facilitation in the translation of evidence informing professional craft knowledge. (Source: Implementation Science)
Source: Implementation Science - May 14, 2009 Category: Health Management Authors: Carol L McWilliam, Anita Kothari, Catherine Ward-Griffin, Dorothy Forbes, Beverley Leipert and SW-CCAC Home Care Collaboration (sw-ccac) Source Type: journals

Research in action: using positive deviance to improve quality of health careEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The identification and examination of health care organizations that demonstrate positive deviance provides an opportunity to characterize and disseminate strategies for improving quality. (Source: Implementation Science)
Source: Implementation Science - May 8, 2009 Category: Health Management Authors: Elizabeth H Bradley, Leslie A Curry, Shoba Ramanadhan, Laura Rowe, Ingrid M Nembhard and Harlan M Krumholz Source Type: journals

Can the collective intentions of individual professionals within healthcare teams predict the team's performance: developing methods and theoryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: These approaches to aggregating individually-administered measures may be a methodological advance of theoretical importance. Using simple means of individual-level measures to explain team-level behaviours is neither theoretically plausible nor empirically supported; the highest intention was both predictive and plausible. In studies aiming to understand the behaviours of teams of healthcare professionals in managing chronic diseases, some sort of aggregation of measures from individuals is necessary. This is not simply a methodological point, but a necessary step in advancing the theoretical and practical un...
Source: Implementation Science - May 5, 2009 Category: Health Management Authors: Martin P Eccles, Susan Hrisos, Jillian J Francis, Nick Steen, Marije Bosch and Marie Johnston Source Type: journals

Improving the delivery of care for patients with diabetes through understanding optimised team work and organisation in primary careEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Background: Type 2 diabetes is an increasingly prevalent chronic illness and is an important cause of avoidable mortality. Patients are managed by the integrated activities of clinical and non-clinical members of the primary care team. Studies of the quality of care for patients with diabetes suggest less than optimum care in a number of areas. Aim The aim of this study is to improve the quality of care for patients with diabetes cared for in primary care in the UK. by identifying individual, team and organisational factors that predict the implementation of best practice. DesignParticipants will be clinical and non-clini...
Source: Implementation Science - April 27, 2009 Category: Health Management Authors: Martin P Eccles, Gillian Hawthorne, Marie Johnston, Margaret Hunter, Nick Steen, Jill Francis, Susan Hrisos, Marko Elovainio and Jeremy M Grimshaw Source Type: journals

A description of a knowledge broker role implemented as part of a randomized controlled trial evaluating three knowledge translation strategiesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: As the knowledge broker role developed during this study, central themes that emerged as particularly important included relationship development, on-going support, customized approaches, and opportunities for individual and organizational capacity development. The novelty of the knowledge broker role in public health provides a unique opportunity to assess the need for and reaction to the role and its associated activities. Future research should include studies to evaluate the effectiveness of knowledge brokers in different settings and among different health care professionals; explore the optimal preparatio...
Source: Implementation Science - April 27, 2009 Category: Health Management Authors: Maureen Dobbins, Paula Robeson, Donna Ciliska, Steve Hanna, Roy Cameron, Linda O'Mara, Kara DeCorby and Shawna Mercer Source Type: journals

Healthcare professionals and managers' participation in developing an intervention : a pre-intervention study in the elderly care contextEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: This article reports on an in-depth pre-intervention study that led to the design and development of an intervention in partnership with local healthcare professionals and managers. The stepwise approach represents an innovative strategy for developing tailored interventions, particularly in complex domains such as chronic care. It highlights the usefulness of seeking out the insight of healthcare professionals and managers and emphasizes the need to intervene at different levels. Further research will be needed in order to develop a more thorough understanding of the impacts of such strategies on the final ou...
Source: Implementation Science - April 21, 2009 Category: Health Management Authors: Isabelle Vedel, Matthieu De Stampa, Howard Bergman, Joel Ankri, Bernard Cassou, Francois Blanchard and Liette Lapointe Source Type: journals

Users' perspectives of barriers and facilitators to implementing EHR in Canada: A study protocolEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
DiscussionGiven the imminence of an interoperable EHR in Canada, knowledge and evidence are urgently needed to prepare this major shift in our healthcare system and to oversee the factors that could affect its adoption and integration by all its potential users. This synthesis will be the first to systematically summarize the barriers and facilitators to EHR adoption perceived by different groups and to consider the local contexts in order to ensure the applicability of this knowledge to the particular realities of various Canadian jurisdictions. This comprehensive and rigorous strategy could be replicated in other setting...
Source: Implementation Science - April 9, 2009 Category: Health Management Authors: Marie-Pierre Gagnon, Nicola Shaw, Claude Sicotte, Luc Mathieu, Yvan Leduc, Julie Duplantie, James Maclean and France Legare Source Type: journals

An implementation research agendaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In October 2006, the Chief Medical Officer (CMO) of England asked Professor Sir John Tooke to chair a High Level Group on Clinical Effectiveness in response to the chapter 'Waste not, want not' in the CMOs 2005 annual report 'On the State of the Public Health'. The high level group made recommendations to the CMO to address possible ways forward to improve clinical effectiveness in the UK National Health Service (NHS) and promote clinical engagement to deliver this. The report contained a short section on research needs that emerged from the process of writing the report, but in order to more fully identify the relevant re...
Source: Implementation Science - April 7, 2009 Category: Health Management Authors: Martin P Eccles, David Armstrong, Richard Baker, Kevin Cleary, Huw Davies, Stephen Davies, Paul Glasziou, Irene Ilott, Ann-Louise Kinmonth, Gillian Leng, Stuart Logan, Theresa Marteau, Susan Michie, Hugh Rogers, Jo Rycroft-Malone and Bonnie Sibbald Source Type: journals