Evidence use in decision-making on introducing innovations: a systematic scoping review with stakeholder feedback

Turner, Simon; D’Lima, Danielle; Hudson, Emma; Morris, Stephen; Sheringham, Jessica; Swart, Nicholas; Fulop, Naomi

doi:10.1186/s13012-017-0669-6

Cited by 48 publications

(52 citation statements)

References 68 publications

(98 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Both studies mention the local champions' facilitating role in starting and advancing the implementation processes of CDSS. Another implementation challenge we found, the role of evidence on innovation implementation, has been discussed extensively in the field of evidence-based healthcare [41]. Scientific evidence is an important determinant of innovation implementation for practitioners, a finding that also appears to hold for AI in radiology [8,21,41,42].…”

Section: Discussionmentioning

confidence: 63%

Implementation of artificial intelligence (AI) applications in radiology: hindering and facilitating factors

et al. 2020

View full text Add to dashboard Cite

Objective The objective was to identify barriers and facilitators to the implementation of artificial intelligence (AI) applications in clinical radiology in The Netherlands. Materials and methods Using an embedded multiple case study, an exploratory, qualitative research design was followed. Data collection consisted of 24 semi-structured interviews from seven Dutch hospitals. The analysis of barriers and facilitators was guided by the recently published Non-adoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework for new medical technologies in healthcare organizations. Results Among the most important facilitating factors for implementation were the following: (i) pressure for cost containment in the Dutch healthcare system, (ii) high expectations of AI’s potential added value, (iii) presence of hospital-wide innovation strategies, and (iv) presence of a “local champion.” Among the most prominent hindering factors were the following: (i) inconsistent technical performance of AI applications, (ii) unstructured implementation processes, (iii) uncertain added value for clinical practice of AI applications, and (iv) large variance in acceptance and trust of direct (the radiologists) and indirect (the referring clinicians) adopters. Conclusion In order for AI applications to contribute to the improvement of the quality and efficiency of clinical radiology, implementation processes need to be carried out in a structured manner, thereby providing evidence on the clinical added value of AI applications. Key Points • Successful implementation of AI in radiology requires collaboration between radiologists and referring clinicians. • Implementation of AI in radiology is facilitated by the presence of a local champion. • Evidence on the clinical added value of AI in radiology is needed for successful implementation.

show abstract

Section: Discussionmentioning

confidence: 63%

Implementation of artificial intelligence (AI) applications in radiology: hindering and facilitating factors

et al. 2020

View full text Add to dashboard Cite

show abstract

“…[4][5][6][7] Many factors have been shown to influence guideline uptake, such as guideline characteristics (eg, ease of implementation, guideline clarity), clinician familiarity with guidelines and evidence, and patient comorbidities or awareness of need. 8,9 Interventions targeting these barriers, such as clinician and patient education or system-level changes like alerts or team-based care, have been shown effective in increasing guideline uptake. 10 However, few studies provide a comprehensive evaluation of how different levels of factors collectively affect guideline uptake.…”

Section: Introductionmentioning

confidence: 99%

Factors Influencing Uptake of Changes to Clinical Preventive Guidelines

et al. 2020

View full text Add to dashboard Cite

Background: Despite widespread recognition that adherence to clinical preventive guidelines improves patient outcomes, clinicians struggle to implement guideline changes in a timely manner. Multiple factors influence guideline adoption and effective implementation. However, few studies evaluate their collective and interrelated effects. This qualitative study provides a comprehensive picture of the interplay between multiple factors on uptake of new or changed preventive guidelines. Methods: Semistructured interviews conducted in 2018 with a diverse sample of clinicians and practice leaders sought to understand patient, clinician, practice, health system, environment, and guideline factors of influence. An immersion-crystallization approach was used to identify emergent themes. Results: Interviewees expressed motivation to adhere to guidelines but also valued sharing decisions with patients. Personal biases and fears affected both clinician and patient guideline adoption. Practices facilitated implementation through workflow optimization and encouraging a culture of evidence-based practice while a key health system function was to maintain electronic health record alerts. More traditional environmental factors, such as insurance coverage or transportation, were less of a barrier to guideline adoption and implementation than the influence of media and specialists. Various specific guideline characteristics also affected ease of adoption and implementation. Different settings expressed greater health system, practice, or clinician-centric approaches to guideline implementation. Conclusions: Guideline uptake is influenced by a complex interplay of multiple levels of factors including the patient, clinician, practice, health system, environment, and guideline levels. Comprehensively understanding all levels of influence for each specific clinical setting may help to determine the optimal intervention(s) for improving uptake of evidence-based guidelines.

show abstract

“…The American Chiropractic Association solution was to ask members to increase collaboration with other health care professionals and become more evidence-based. While laudable, it may be simplistic to expect that a profession can change quickly in this regard as such change is likely to be slow to happen and difficult to implement [ 26 ]. In order to obtain change, the target group should be as geographically local as possible, value diverse evidence and involve the use of multimethod programs [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Comparing the old to the new: A comparison of similarities and differences of the accreditation standards of the chiropractic council on education-international from 2010 to 2016

2018

View full text Add to dashboard Cite

BackgroundChiropractic programs are accredited and monitored by regional Councils on Chiropractic Education (CCE). The CCE-International has historically been a federation of regional CCEs charged with harmonising world standards to produce quality chiropractic educational programs. The standards for accreditation periodically undergo revision. We conducted a comparison of the CCE-International 2016 Accreditation Standards with the previous version, looking for similarities and differences, expecting to see some improvements.MethodThe CCE-International current (2016) and previous versions (2010) were located and downloaded. Word counts were conducted for words thought to reflect content and differences between standards. These were tabulated to identify similarities and differences. Interpretation was made independently followed by discussion between two researchers.ResultsThe 2016 standards were nearly 3 times larger than the previous standards. The 2016 standards were created by mapping and selection of common themes from member CCEs’ accreditation standards and not through an evidence-based approach to the development and trialling of accreditation standards before implementation. In 2010 chiropractors were expected to provide attention to the relationship between the structural and neurological aspects of the body in health and disease. In 2016 they should manage mechanical disorders of the musculoskeletal system. Many similarities between the old and the new standards were found. Additions in 2016 included a hybrid model of accreditation founded on outcomes-based assessment of education and quality improvement. Both include comprehensive competencies for a broader role in public health. Omissions included minimal faculty qualifications and the requirement that students should be able to critically appraise scientific and clinical knowledge. Another omission was the requirement for chiropractic programs to be part of a not-for-profit educational entity. There was no mention of evidence-based practice in either standards but the word ‘evidence-informed’ appeared once in the 2016 standards.ConclusionsSome positive changes have taken place, such as having bravely moved towards the musculoskeletal model, but on the negative side, the requirement to produce graduates skilled at dealing with scientific texts has been removed. A more robust development approach including better transparency is needed before implementation of CCE standards and evidence-based concepts should be integrated in the programs. The CCE-International should consider the creation of a recognition of excellence in educational programs and not merely propose minimal standards.

show abstract

Evidence use in decision-making on introducing innovations: a systematic scoping review with stakeholder feedback

Cited by 48 publications

References 68 publications

Implementation of artificial intelligence (AI) applications in radiology: hindering and facilitating factors

Implementation of artificial intelligence (AI) applications in radiology: hindering and facilitating factors

Factors Influencing Uptake of Changes to Clinical Preventive Guidelines

Comparing the old to the new: A comparison of similarities and differences of the accreditation standards of the chiropractic council on education-international from 2010 to 2016

Contact Info

Product

Resources

About