As a starting point when choosing a framework , an organization may review published evidence to understand what and how framework ( s ) were used successfully and compare them to their local context .”
They add that demonstrating successfully sustained implementation should include evidence of sustainment , that is , sustained use of an evidence-based intervention ( process measure ), and sustainability , that is , sustained benefits of an evidence-based intervention ( outcome measure ).
But it may also take openness to change on the part of all stakeholders in the healthcare environment .
“ There ’ s a wonderful book called Switch : How to Change Things When Change Is Hard , written by Chip Heath and Dan Heath that discusses what it takes to change . Often , objective observation led to the answer . It took open-mindedness , not making assumptions and just watching processes and asking why resistance was occurring ,” Schaffzin adds . “ The people in healthcare who do that the best are infection preventionists and infectious disease specialists , and that ’ s why we are asked for help in determining why something is happening , and what can we do about it . That , to me , is where we are going with implementation , and being able to answer those key questions and practicing according to the evidence .”
Pettis acknowledges the numerous contributing factors to hospitals ’ struggles with implementation science .
“ Mainly it may come down to resources whether it be staff , finances , mentors , frequent turnover in the IP department , lack of a hospital epidemiologist , etc .,” she says . “ There may be a lack of organizational or leadership buy-in ; the project team may be out of step with organizational priorities or values . There is often a lack of training in the basic principles of implementation science which often leads to pressure to accomplish the goal quickly so there ’ s no sustainability over time … in other words , nothing ‘ sticks .’ As the saying goes , ‘ You have to go slow to go fast .’”
References :
Eccles MP , Mittman BS . Welcome to implementation science . Implement Sci . 2006 ; 1:1 .
Geerligs L , Rankin NM , Shepherd HL and Butow P . Hospital-based interventions : a systematic review of staff-reported barriers and facilitators to implementation processes . Implementation Sci . Vol . 13 , No . 36 . Feb . 23 , 2018 .
Institute for Healthcare Improvement ( IHI ). Science of Improvement : Establishing measures . 2023 .
Pronovost PJ , Berenholtz SM , Needham DM . Translating evidence into practice : A model for large scale knowledge translation . BMJ 2008 ; 337 : a1714 .
Trivedi KK , Schaffzin JK , et al . Implementing strategies to prevent infections in acute-care settings . Infection Control & Hospital Epidemiology . April 2023 . 1-15 . doi : 10.1017 / ice . 2023.103
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