The application of implementation science to advance quality improvement in healthcare is the subject of discussion in an article written by Mohammad A. Al-Tannir and published in the Journal of Healthcare Leadership. The article is titled “Implementation Science and Its Role in Advancing Quality Improvement in Healthcare.” The location of the medical facility is a sizable academic medical center in the Kingdom of Saudi Arabia. Patients are the focus of the quality initiative’s efforts to cut down on the number of cases of hospital-acquired infections (HAIs). A quasi-experimental design with both a pre- and post-intervention analysis was utilized as the methodology for this study. In order to conduct the research, a program for the prevention and control of infections was put into place. This program featured instructional sessions, audits, and feedback for medical personnel. The end result was a drop in the incidence of HAIs that was significantly lower than expected, coming in at 2.6% rather than 6.8%.
The author based the execution of the infection prevention and control program on the Consolidated Framework for Implementation Research (CFIR), which is a research framework that has been consolidated. The CFIR is an all-encompassing framework that takes into account a number of different structures that are important to the process of implementation. These constructs include the external environment, the internal setting, and the unique qualities of those who are participating.
The author mentioned a number of obstacles that stand in the way of implementation, some of which include reluctance to change, a lack of awareness and understanding among healthcare personnel, and a scarcity of resources. The author addressed these challenges by delivering information and training to healthcare professionals, integrating stakeholders in the process of implementation, and devoting additional resources to the infection prevention and control program.
The reduction in the number of HAIs that occurred in the six months after the intervention demonstrated that the change that was obtained was one that could be maintained over time. The Plan-Do-Study-Act (PDSA) cycle is an example of a different approach to quality improvement that may have been utilized instead (McNicholas et al., 2019). PDSA stands for “Planning, Doing, Studying, and Acting,” and it is an approach to continuous improvement that entails planning a change, doing the change, researching the outcomes, and then acting on the results to make additional changes. This approach had the potential to be utilized in the iterative enhancement of the infection prevention and control program over the course of time.
The relevance of having a comprehensive framework to guide implementation and the necessity of addressing barriers to implementation in order to achieve continuous progress are two significant takeaways from this essay. Both of these takeaways are important. These learnings would be incorporated into future quality improvement projects that I work on by choosing a framework that takes into account the particular circumstances of the project and beginning the process by resolving any obstacles that stand in the way of its successful implementation.
Reference
McNicholas, C., Lennox, L., Woodcock, T., Bell, D., & Reed, J. E. (2019). Evolving quality improvement support strategies to improve Plan–Do–Study–Act cycle fidelity: a retrospective mixed-methods study. BMJ quality & safety, 28(5), 356-365.
this is 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:
The article “Implementation Science and Its Role in Advancing Quality Improvement in Healthcare” by Mohammad A. Al-Tannir, discusses the use of implementation science to improve the quality of healthcare in a Saudi Arabian medical center. In this article summary, the healthcare setting, quality initiative, methodology, outcomes, framework for implementation, barriers to implementation, sustained quality improvement, recommended quality improvement methods, and two key takeaways from the article are discussed.
The healthcare center in focus is a sizable academic medical center in the Kingdom of Saudi Arabia. The quality initiative focused on reducing the number of cases of hospital-acquired infections (HAIs) among patients. A quasi-experimental design with both pre- and post-intervention analysis was used as the methodology for this study. A program for the prevention and control of infections was introduced and included instructional sessions, audits, and feedback for medical personnel. The outcome of the program was a significant decrease in the incidence of HAIs to 2.6% from 6.8%.
The Consolidated Framework for Implementation Research (CFIR) was the framework used to guide the implementation process. The CFIR considers various structures essential for the process of implementation, including internal and external settings, as well as those who are participating. Barriers to implementation included resistance to change, lack of awareness and understanding among healthcare professionals, and a lack of resources. To address these barriers, the author provided training and information to healthcare professionals, included stakeholders in the implementation process, and allocated more resources to the infection prevention and control program.
The significant decrease in HAIs achieved in the six months after the intervention demonstrated that the change could be sustained over time. As an alternative approach, the Plan-Do-Study-Act (PDSA) cycle could have been utilized for iterative enhancement of the infection prevention and control program over time.
Two key takeaways from this article are the relevance of having a comprehensive framework to guide implementation and the need to address barriers to implementation. These learnings would inform future quality improvement projects by choosing an appropriate framework that accounts for project circumstances and addressing barriers to successful implementation.
In conclusion, this article highlights the importance of implementation science in advancing quality improvement in healthcare. The use of appropriate frameworks and methods and addressing barriers to implementation enabled sustained quality improvement in this medical center.
