Developing evidence‐based practice champions in the <scp>M</scp>aldives

Shifaza, Fathimath; Evans, David; Bradley, Helen; Ullrich, Sandra

doi:10.1111/ijn.12106

Cited by 8 publications

(7 citation statements)

References 26 publications

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“…Often, the literature implies that effective champions have certain intrinsic qualities that cannot be taught [ 30 , 31 , 37 ]. The few articles that do address increasing champions’ efficacy recommend fairly vague strategies such as creating and sustaining learning communities, ongoing mentoring and feedback, fostering the development of leadership and change management skills, and valuing and rewarding champions for their contribution, coupled with hands-on practice and content-specific training [ 36 , 38 ]. Relevant recommendations note only the need to “identify and prepare individuals who dedicate themselves to supporting, marketing, and driving through an implementation” [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…All study community health centers were required to identify a staff member to engage with the study team and lead the clinic’s efforts to support the use of the CVD bundle—a study implementer. Based on known attributes of effective champions [ 30 , 31 , 36 – 38 ], and our past experience [ 39 ], we suggested (but did not define or require) selecting implementers with involvement in and enthusiasm about quality improvement activities, credibility, and influence at the clinic, and interest in diabetes/cardiovascular care. One staff member could be the study implementer for up to three clinics in a single community health center.…”

Section: Methodsmentioning

confidence: 99%

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Lessons learned about the effective operationalization of champions as an implementation strategy: results from a qualitative process evaluation of a pragmatic trial

et al. 2020

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Background Though the knowledge base on implementation strategies is growing, much remains unknown about how to most effectively operationalize these strategies in diverse contexts. For example, while evidence shows that champions can effectively support implementation efforts in some circumstances, little has been reported on how to operationalize this role optimally in different settings, or on the specific pathways through which champions enact change. Methods This is a secondary analysis of data from a pragmatic trial comparing implementation strategies supporting the adoption of guideline-concordant cardioprotective prescribing in community health centers in the USA. Quantitative data came from the community health centers’ shared electronic health record; qualitative data sources included community health center staff interviews over 3 years. Using a convergent mixed-methods design, data were collected concurrently and merged for interpretation to identify factors associated with improved outcomes. Qualitative analysis was guided by the constant comparative method. As results from the quantitative and initial qualitative analyses indicated the essential role that champions played in promoting guideline-concordant prescribing, we conducted multiple immersion-crystallization cycles to better understand this finding. Results Five community health centers demonstrated statistically significant increases in guideline-concordant cardioprotective prescribing. A combination of factors appeared key to their successful practice change: (1) A clinician champion who demonstrated a sustained commitment to implementation activities and exhibited engagement, influence, credibility, and capacity; and (2) organizational support for the intervention. In contrast, the seven community health centers that did not show improved outcomes lacked a champion with the necessary characteristics, and/or organizational support. Case studies illustrate the diverse, context-specific pathways that enabled or prevented study implementers from advancing practice change. Conclusion This analysis confirms the important role of champions in implementation efforts and offers insight into the context-specific mechanisms through which champions enact practice change. The results also highlight the potential impact of misaligned implementation support and key modifiable barriers and facilitators on implementation outcomes. Here, unexamined assumptions and a lack of evidence-based guidance on how best to identify and prepare effective champions led to implementation support that failed to address important barriers to intervention success. Trial registration ClinicalTrials.gov, NCT02325531. Registered 15 December 2014.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Lessons learned about the effective operationalization of champions as an implementation strategy: results from a qualitative process evaluation of a pragmatic trial

et al. 2020

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“…Thus, the formal champion relies on hierarchical power, autonomy, and credibility (e.g. Ploeg et al, 2010;Shifaza, Evans, Bradley, & Ullrich, 2013). According to Helfrich, Weiner, McKinney, and Minasian (2007), formal champions are key individuals in healthcare organizations because they are officially assigned with seeking and managing potential innovations.…”

Section: Introductionmentioning

confidence: 99%

“…nurses, physicians, patients) are involved, might be more suitable for a formal champion, who enjoys more hierarchical power, access to organizational resources, and managerial support than an informal champion (e.g. Day, 1994;Howell & Higgins, 1990a;McCorkle, Alexander, & Reardon, 2001;Ploeg et al, 2010;Shifaza et al, 2013;van Laere & Aggestam, 2016).…”

mentioning

confidence: 99%

Characteristics and behaviours of formal versus informal nurse champions and their relationship to innovation success

Luz

Shadmi

Admi

et al. 2018

Journal of Advanced Nursing

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Formal and informal champions differ in their characteristics and implementation strategies. To encourage project's innovation, the organizational climate should encourage the emergence of informal champions; formal and informal champions should be chosen wisely, assuring that they possess enough organizational resources; and coaching programmes for junior champions should be planned to equip them with championing behaviours.

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“…Burnett, Lewis, Joy, and Jarrett () identified bedside nurses as champions to measure the reliability and validity of a fall assessment risk tool utilized in their institution. Shifaza, Evans, Bradley, and Ullrich () described their strategy to encourage the uptake of evidence‐based practice by recruiting and training clinical champions in evidence‐based changes. By building a network of champion clinicians, they were able to assist their colleagues in applying principles and tools of evidence‐based practice.…”

Section: Discussionmentioning

confidence: 99%