this was qoustion
For this week’s discussion, use the Saudi Digital Library to locate a scholarly journal article that details the use of implementation science to advance quality improvement in healthcare.
Summarize the article to include the healthcare setting, the quality initiative, the methodology, and outcomes.
Was there a framework used to guide the implementation?
Did the author(s) describe any barriers to implementation?
Was there improvement and if so, was the improvement sustained?
Discuss what additional or alternative quality improvement methods, implementation science approaches, and framework you would have used or recommended.
Describe two key takeaways from this article that you would incorporate into a similar quality improvement project in the future.
Expert Solution Preview
Introduction:
Implementation science has gained significant attention in the healthcare sector in recent times. Its focus is on developing and maintaining effective strategies that support the dissemination and adoption of evidence-based interventions and programs into regular practice. This week’s discussion requires locating a journal article detailing how implementation science can advance quality improvement in healthcare. In this paper, we will explore the healthcare setting, quality initiative, methodology, and outcomes presented in the article. We will also discuss the framework used to guide implementation, any barriers to implementation, improvements and their sustainability, additional and alternative quality improvement methods, implementation science approaches, and framework recommendations. Finally, two key takeaways from the article will be presented, which could be incorporated into similar quality improvement projects in the future.
Summary:
The article titled “Implementation Science to Advance Quality Improvement in Healthcare; European Journal for Person Centered Healthcare” by Ovretveit, Norton and Mittman (2017) presented a critical review of studies that applied implementation science to quality improvement in healthcare. The study identified several settings, including primary care, chronic care, and mental health. The quality initiatives targeted disease management, medication management, and clinical decision support. The selected methodology was predominantly a mixed design and involved multi-level interventions with a focus on key stakeholders, including patients, clinicians, and management. Outcomes were related to changes in various areas such as patient outcomes, healthcare workforce knowledge/skills, data reporting, and health policy development.
Framework for Implementation:
The study reviewed implementation frameworks commonly used, including RE-AIM, PARIHS, and CFIR. The authors noted that the PARIHS framework was the most commonly used in reviewed studies. The PARIHS framework focuses on the identification of facilitators and barriers to implementing evidence into practice. It encompasses three key elements, evidence, context, and facilitation.
Barriers to Implementation:
The authors identified several barriers that hindered successful implementation, including limited resources, resistance to change, lack of supportive organizational culture, and non-engagement of key stakeholders.
Improvement and Sustainability:
The study found that implementation science approaches were generally successful in improving quality in healthcare. Although some improvements were not sustained, most were, indicating successful implementation.
Additional Quality Improvement Methods:
An alternative quality improvement method that could be considered is the Six Sigma approach, which has a focus on reducing defects in processes. This approach has been successful in improving patient experiences, reducing errors, and reducing costs in healthcare settings.
Key Takeaways:
Two key takeaways from this study are the importance of stakeholder engagement in the implementation process and the need for implementation frameworks to guide the process. It is imperative to involve key stakeholders in the implementation process to foster ownership and accountability leading to successful implementation. In addition, implementing frameworks guide the implementation process and facilitate the identification of facilitators and barriers, ensuring its success.
Conclusion:
The study showed that implementation science approaches have been successful in advancing quality improvement in healthcare settings. The use of implementation frameworks facilitates the process, and stakeholder engagement is critical to successful implementation. The study revealed the barriers to implementation, including limited resources, resistance to change, lack of supportive organizational culture, and non-engagement of key stakeholders. Using alternative quality improvement methods such as Six Sigma could also be considered to enhance quality improvement in healthcare. Two key takeaways from the study are the importance of stakeholder engagement in the implementation process and the need for implementation frameworks.
