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Implementation Science: IS

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https://www.readbyqxmd.com/read/29347952/the-german-quality-network-sepsis-study-protocol-for-the-evaluation-of-a-quality-collaborative-on-decreasing-sepsis-related-mortality-in-a-quasi-experimental-difference-in-differences-design
#1
Daniel Schwarzkopf, Hendrik Rüddel, Matthias Gründling, Christian Putensen, Konrad Reinhart
BACKGROUND: While sepsis-related mortality decreased substantially in other developed countries, mortality of severe sepsis remained as high as 44% in Germany. A recent German cluster randomized trial was not able to improve guideline adherence and decrease sepsis-related mortality within the participating hospitals, partly based on lacking support by hospital management and lacking resources for documentation of prospective data. Thus, more pragmatic approaches are needed to improve quality of sepsis care in Germany...
January 18, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29334983/an-individually-tailored-family-centered-intervention-for-pediatric-obesity-in-primary-care-study-protocol-of-a-randomized-type-ii-hybrid-effectiveness-implementation-trial-raising-healthy-children-study
#2
Justin D Smith, Cady Berkel, Neil Jordan, David C Atkins, Shrikanth S Narayanan, Carlos Gallo, Kevin J Grimm, Thomas J Dishion, Anne M Mauricio, Jenna Rudo-Stern, Mariah K Meachum, Emily Winslow, Meg M Bruening
BACKGROUND: Pediatric obesity is a multi-faceted public health concern that can lead to cardiovascular diseases, cancers, and early mortality. Small changes in diet, physical activity, or BMI can significantly reduce the possibility of developing cardiometabolic risk factors. Family-based behavioral interventions are an underutilized, evidence-based approach that have been found to significantly prevent excess weight gain and obesity in children and adolescents. Poor program availability, low participation rates, and non-adherence are noted barriers to positive outcomes...
January 15, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29325592/magnesium-sulphate-for-fetal-neuroprotection-to-prevent-cerebral-palsy-mag-cp-implementation-of-a-national-guideline-in-canada
#3
Dane A De Silva, Anne R Synnes, Peter von Dadelszen, Tang Lee, Jeffrey N Bone, Laura A Magee
BACKGROUND: Evidence supports magnesium sulphate (MgSO4) for women at risk of imminent birth at < 32-34 weeks to reduce the likelihood of cerebral palsy in the child. MAGnesium sulphate for fetal neuroprotection to prevent Cerebral Palsy (MAG-CP) was a multifaceted knowledge translation (KT) strategy for this practice. METHODS: The KT strategy included national clinical practice guidelines, a national online e-learning module and, at MAG-CP sites, educational rounds, focus group discussions and surveys of barriers and facilitators...
January 11, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29321043/what-is-in-your-wallet-a-cluster-randomized-trial-of-the-effects-of-showing-comparative-patient-out-of-pocket-costs-on-primary-care-prescribing-for-uncomplicated-hypertension
#4
Robyn Tamblyn, Nancy Winslade, Christina J Qian, Teresa Moraga, Allen Huang
BACKGROUND: Drug expenditures are responsible for an increasing proportion of health costs, accounting for $1.1 trillion in annual expenditure worldwide. As hundreds of billions of dollars are being spent each year on overtreatment with prescribed medications that are either unnecessary or are in excess of lowest cost-effective therapy, programs are needed that optimize fiscally appropriate use. We evaluated whether providing physicians with information on the patient out-of-pocket payment consequences of prescribing decisions that were in excess of lowest cost-effective therapy would alter prescribing decisions using the treatment of uncomplicated hypertension as an exemplar...
January 10, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29316945/the-implementation-of-academic-detailing-and-its-effectiveness-on-appropriate-prescribing-of-pain-relief-medication-a-real-world-cluster-randomized-trial-in-belgian-general-practices
#5
Robin Bruyndonckx, Veronique Verhoeven, Sibyl Anthierens, Koen Cornelis, Katelijne Ackaert, Birgit Gielen, Samuel Coenen
BACKGROUND: In Belgium, the debate about the effect of the national academic detailing service (ADS) on prescribing quality in general practice is ongoing. In order to evaluate both the implementation strategies of the ADS and its effectiveness on appropriate prescribing of pain relief medication, we conducted a real-world cluster randomized controlled trial (cRCT). METHODS: In a pragmatic cRCT, all Belgian general practices previously visited by Farmaka were assessed for eligibility and randomized...
January 10, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29310683/exploring-multi-level-system-factors-facilitating-educator-training-and-implementation-of-evidence-based-practices-ebp-a-study-protocol
#6
Aubyn C Stahmer, Jessica Suhrheinrich, Patricia L Schetter, Elizabeth McGee Hassrick
BACKGROUND: This study examines how system-wide (i.e., region, district, and school) mechanisms such as leadership support, training requirements, structure, collaboration, and education affect the use of evidence-based practices (EBPs) in schools and how this affects the outcomes for students with autism spectrum disorder (ASD). Despite growing evidence for the positive effects of EBPs for ASD, these practices are not consistently or effectively used in schools. Although special education programs are mandated to use EBPs, there are very few evidence-based methods for selecting, implementing, and sustaining EBPs...
January 8, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29310673/assessing-organizational-implementation-context-in-the-education-sector-confirmatory-factor-analysis-of-measures-of-implementation-leadership-climate-and-citizenship
#7
Aaron R Lyon, Clayton R Cook, Eric C Brown, Jill Locke, Chayna Davis, Mark Ehrhart, Gregory A Aarons
BACKGROUND: A substantial literature has established the role of the inner organizational setting on the implementation of evidence-based practices in community contexts, but very little of this research has been extended to the education sector, one of the most common settings for the delivery of mental and behavioral health services to children and adolescents. The current study examined the factor structure, psychometric properties, and interrelations of an adapted set of pragmatic organizational instruments measuring key aspects of the organizational implementation context in schools: (1) strategic implementation leadership, (2) strategic implementation climate, and (3) implementation citizenship behavior...
January 8, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29301543/towards-evidence-based-palliative-care-in-nursing-homes-in-sweden-a-qualitative-study-informed-by-the-organizational-readiness-to-change-theory
#8
Per Nilsen, Birgitta Wallerstedt, Lina Behm, Gerd Ahlström
BACKGROUND: Sweden has a policy of supporting older people to live a normal life at home for as long as possible. Therefore, it is often the oldest, most frail people who move into nursing homes. Nursing home staff are expected to meet the existential needs of the residents, yet conversations about death and dying tend to cause emotional strain. This study explores organizational readiness to implement palliative care based on evidence-based guidelines in nursing homes in Sweden. The aim was to identify barriers and facilitators to implementing evidence-based palliative care in nursing homes...
January 4, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29282135/implementation-of-a-relatives-toolkit-impart-study-an-iterative-case-study-to-identify-key-factors-impacting-on-the-implementation-of-a-web-based-supported-self-management-intervention-for-relatives-of-people-with-psychosis-or-bipolar-experiences-in-a-national
#9
Fiona Lobban, Victoria Appleton, Duncan Appelbe, Johanna Barraclough, Julie Bowland, Naomi R Fisher, Sheena Foster, Sonia Johnson, Elizabeth Lewis, Céu Mateus, Barbara Mezes, Elizabeth Murray, Puffin O'Hanlon, Vanessa Pinfold, Jo Rycroft-Malone, Ron Siddle, Jo Smith, Chris J Sutton, Andrew Walker, Steven H Jones
BACKGROUND: Web-based interventions to support people to manage long-term health conditions are available and effective but rarely used in clinical services. The aim of this study is to identify critical factors impacting on the implementation of an online supported self-management intervention for relatives of people with recent onset psychosis or bipolar disorder into routine clinical care and to use this information to inform an implementation plan to facilitate widespread use and inform wider implementation of digital health interventions...
December 28, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29282080/safety-analysis-over-time-seven-major-changes-to-adverse-event-investigation
#10
Charles Vincent, Jane Carthey, Carl Macrae, Rene Amalberti
BACKGROUND: Every safety-critical industry devotes considerable time and resource to investigating and analysing accidents, incidents and near misses. The systematic analysis of incidents has greatly expanded our understanding of both the causes and prevention of harm. These methods have been widely employed in healthcare over the last 20 years but are now subject to critique and reassessment. In this paper, we reconsider the purpose and value of incident analysis and methods appropriate to the healthcare of today...
December 28, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29258601/preliminary-testing-of-the-reliability-and-feasibility-of-sage-a-system-to-measure-and-score-engagement-with-and-use-of-research-in-health-policies-and-programs
#11
Steve R Makkar, Anna Williamson, Catherine D'Este, Sally Redman
BACKGROUND: Few measures of research use in health policymaking are available, and the reliability of such measures has yet to be evaluated. A new measure called the Staff Assessment of Engagement with Evidence (SAGE) incorporates an interview that explores policymakers' research use within discrete policy documents and a scoring tool that quantifies the extent of policymakers' research use based on the interview transcript and analysis of the policy document itself. We aimed to conduct a preliminary investigation of the usability, sensitivity, and reliability of the scoring tool in measuring research use by policymakers...
December 19, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29258551/community-based-participatory-research-and-integrated-knowledge-translation-advancing-the-co-creation-of-knowledge
#12
Janet Jull, Audrey Giles, Ian D Graham
BACKGROUND: Better use of research evidence (one form of "knowledge") in health systems requires partnerships between researchers and those who contend with the real-world needs and constraints of health systems. Community-based participatory research (CBPR) and integrated knowledge translation (IKT) are research approaches that emphasize the importance of creating partnerships between researchers and the people for whom the research is ultimately meant to be of use ("knowledge users")...
December 19, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29246236/feasibility-and-acceptability-of-two-incentive-based-implementation-strategies-for-mental-health-therapists-implementing-cognitive-behavioral-therapy-a-pilot-study-to-inform-a-randomized-controlled-trial
#13
Rinad S Beidas, Emily M Becker-Haimes, Danielle R Adams, Laura Skriner, Rebecca E Stewart, Courtney Benjamin Wolk, Alison M Buttenheim, Nathaniel J Williams, Patricia Inacker, Elizabeth Richey, Steven C Marcus
BACKGROUND: Informed by our prior work indicating that therapists do not feel recognized or rewarded for implementation of evidence-based practices, we tested the feasibility and acceptability of two incentive-based implementation strategies that seek to improve therapist adherence to cognitive-behavioral therapy for youth, an evidence-based practice. METHODS: This study was conducted over 6 weeks in two community mental health agencies with therapists (n = 11) and leaders (n = 4)...
December 15, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29212546/electronic-laboratory-medicine-ordering-with-evidence-based-order-sets-in-primary-care-elmo-study-protocol-for-a-cluster-randomised-trial
#14
Nicolas Delvaux, An De Sutter, Stijn Van de Velde, Dirk Ramaekers, Steffen Fieuws, Bert Aertgeerts
BACKGROUND: Laboratory testing is an important clinical act with a valuable role in screening, diagnosis, management and monitoring of diseases or therapies. However, inappropriate laboratory test ordering is frequent, burdening health care spending and negatively influencing quality of care. Inappropriate tests may also result in false-positive results and potentially cause excessive downstream activities. Clinical decision support systems (CDSSs) have shown promising results to influence the test-ordering behaviour of physicians and to improve appropriateness...
December 6, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29208000/dynamics-behind-the-scale-up-of-evidence-based-obesity-prevention-protocol-for-a-multi-site-case-study-of-an-electronic-implementation-monitoring-system-in-health-promotion-practice
#15
Kathleen P Conte, Sisse Groen, Victoria Loblay, Amanda Green, Andrew Milat, Lina Persson, Christine Innes-Hughes, Jo Mitchell, Sarah Thackway, Mandy Williams, Penelope Hawe
BACKGROUND: The effectiveness of many interventions to promote health and prevent disease has been well established. The imperative has therefore shifted from amassing evidence about efficacy to scale-up to maximise population-level health gains. Electronic implementation monitoring, or 'e-monitoring', systems have been designed to assist and track the delivery of preventive policies and programs. However, there is little evidence on whether e-monitoring systems improve the dissemination, adoption, and ongoing delivery of evidence-based preventive programs...
December 6, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29202782/studying-de-implementation-in-health-an-analysis-of-funded-research-grants
#16
Wynne E Norton, Amy E Kennedy, David A Chambers
BACKGROUND: Studying de-implementation-defined herein as reducing or stopping the use of a health service or practice provided to patients by healthcare practitioners and systems-has gained traction in recent years. De-implementing ineffective, unproven, harmful, overused, inappropriate, and/or low-value health services and practices is important for mitigating patient harm, improving processes of care, and reducing healthcare costs. A better understanding of the state-of-the-science is needed to guide future objectives and funding initiatives...
December 4, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29202772/evidence-use-in-decision-making-on-introducing-innovations-a-systematic-scoping-review-with-stakeholder-feedback
#17
REVIEW
Simon Turner, Danielle D'Lima, Emma Hudson, Stephen Morris, Jessica Sheringham, Nick Swart, Naomi J Fulop
BACKGROUND: A range of evidence informs decision-making on innovation in health care, including formal research findings, local data and professional opinion. However, cultural and organisational factors often prevent the translation of evidence for innovations into practice. In addition to the characteristics of evidence, it is known that processes at the individual level influence its impact on decision-making. Less is known about the ways in which processes at the professional, organisational and local system level shape evidence use and its role in decisions to adopt innovations...
December 4, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29191230/implementation-fidelity-trajectories-of-a-health-promotion-program-in-multidisciplinary-settings-managing-tensions-in-rehabilitation-care
#18
Femke Hoekstra, Marjolein A G van Offenbeek, Rienk Dekker, Florentina J Hettinga, Trynke Hoekstra, Lucas H V van der Woude, Cees P van der Schans
BACKGROUND: Although the importance of evaluating implementation fidelity is acknowledged, little is known about heterogeneity in fidelity over time. This study aims to generate insight into the heterogeneity in implementation fidelity trajectories of a health promotion program in multidisciplinary settings and the relationship with changes in patients' health behavior. METHODS: This study used longitudinal data from the nationwide implementation of an evidence-informed physical activity promotion program in Dutch rehabilitation care...
December 1, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29187217/the-effects-of-care-bundles-on-patient-outcomes-a-systematic-review-and-meta-analysis
#19
REVIEW
Jacqueline F Lavallée, Trish A Gray, Jo Dumville, Wanda Russell, Nicky Cullum
BACKGROUND: Care bundles are a set of three to five evidence-informed practices performed collectively and reliably to improve the quality of care. Care bundles are used widely across healthcare settings with the aim of preventing and managing different health conditions. This is the first systematic review designed to determine the effects of care bundles on patient outcomes and the behaviour of healthcare workers in relation to fidelity with care bundles. METHODS: This systematic review is reported in line with the PRISMA statement for reporting systematic reviews and meta-analyses...
November 29, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29178960/the-impact-of-a-physician-detailing-and-sampling-program-for-generic-atorvastatin-an-interrupted-time-series-analysis
#20
Heather C Worthington, Lucy Cheng, Sumit R Majumdar, Steven G Morgan, Colette B Raymond, Stephen B Soumerai, Michael R Law
BACKGROUND: In 2011, Manitoba implemented a province-wide program of physician detailing and free sampling for generic atorvastatin to increase use of this generic statin. We examined the impact of this unique combined program of detailing and sampling for generic atorvastatin on the use and cost of statin medicines, market share of generic atorvastatin, the choice of starting statin for new users, and switching from a branded statin to generic atorvastatin. METHODS: We conducted a retrospective study of Manitoba insurance claims data for all continuously enrolled patients who filled one or more prescriptions for a statin between 2008 and 2013...
November 25, 2017: Implementation Science: IS
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