Factors influencing national implementation of innovations within community pharmacy: a systematic review applying the Consolidated Framework for Implementation Research
Abstract:Background
To meet emergent healthcare needs, innovations need to be implemented into routine clinical practice. Community pharmacy is increasingly considered a setting through which innovations can be implemented to achieve positive service and clinical outcomes. Small-scale pilot programmes often need scaled up nation-wide to affect population level change. This systematic review aims to identify facilitators and barriers to the national implementation of community pharmacy innovations.
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“…Besides, the positive role of subjective norm also highlighted the impact of peer and organization as mentioned above. Additionally, as con rmed by previous researches, organizational norms and values control the way individuals interact with each other within or outside the boundaries of the organization, which also directly impacts the health technology diffusion [28,34]. Apart from these factors, domains of technical drivers and external environment are also signi cant dynamics components that cannot be ignored in health technology diffusion in RMC.…”
Section: Discussionmentioning
confidence: 76%
“…And perceived behavioral control is often de ned as perceived ease or di culty of successfully performing a behavior. With respect to DCP test adoption and use, physicians' positive or negative attitude re ects different predispositions [27,28]. And for the physicians working in a clear hierarchy system such as the RMC, opinions on DCP test from leaders, supervisors and colleagues are forces to be reckoned with [29][30][31].…”
Background: Limited diffusion and utilization of health technology have greatly halted the improvement of resource integration and healthcare outcomes. However, the dynamic mechanism of health technology diffusion in the context of the integrated care system (ICS) remained largely unknown. The purpose of this study is to develop and validate the scale on Dynamics of Health Technology Diffusion in Integrated Care System (DHTDICS) for providing instruments to investigate the health technology diffusion in the ICS. Methods: The scale with 39 items was initially designed on the basis of the proposed model developed from previous research. And it was validated in a cross-sectional questionnaire survey including 246 participants. Exploratory factor analysis was used to assess domains in the questionnaire, and analyzed correlation, factorials, internal consistency and validity of the questionnaire. In addition, structural equation modeling was performed to determine the total effects of each domain on the health technology diffusion in the ICS.Results: Reliability analysis revealed excellent internal consistency, as the value of Cronbach’s alpha greater than 0.80 for all of the four DHTDICS domains in this study. An acceptable validity was confirmed through tests of construct validity, convergent validity and discriminant validity. With respect to the potential domains and dimensions that DHTDICS contributes, the results highlight the existence of 4 domains: personal beliefs, technical drivers, organizational readiness, and external environment. Among them, the impact on health technology diffusion is, in descending order, organizational readiness, personal beliefs, external environment, and technical drivers.Conclusions: The findings of this study support the validity of the DHTDICS, and will be a helpful reference for developing future intervention strategies to promote health technology diffusion in the ICS.
“…Besides, the positive role of subjective norm also highlighted the impact of peer and organization as mentioned above. Additionally, as con rmed by previous researches, organizational norms and values control the way individuals interact with each other within or outside the boundaries of the organization, which also directly impacts the health technology diffusion [28,34]. Apart from these factors, domains of technical drivers and external environment are also signi cant dynamics components that cannot be ignored in health technology diffusion in RMC.…”
Section: Discussionmentioning
confidence: 76%
“…And perceived behavioral control is often de ned as perceived ease or di culty of successfully performing a behavior. With respect to DCP test adoption and use, physicians' positive or negative attitude re ects different predispositions [27,28]. And for the physicians working in a clear hierarchy system such as the RMC, opinions on DCP test from leaders, supervisors and colleagues are forces to be reckoned with [29][30][31].…”
Background: Limited diffusion and utilization of health technology have greatly halted the improvement of resource integration and healthcare outcomes. However, the dynamic mechanism of health technology diffusion in the context of the integrated care system (ICS) remained largely unknown. The purpose of this study is to develop and validate the scale on Dynamics of Health Technology Diffusion in Integrated Care System (DHTDICS) for providing instruments to investigate the health technology diffusion in the ICS. Methods: The scale with 39 items was initially designed on the basis of the proposed model developed from previous research. And it was validated in a cross-sectional questionnaire survey including 246 participants. Exploratory factor analysis was used to assess domains in the questionnaire, and analyzed correlation, factorials, internal consistency and validity of the questionnaire. In addition, structural equation modeling was performed to determine the total effects of each domain on the health technology diffusion in the ICS.Results: Reliability analysis revealed excellent internal consistency, as the value of Cronbach’s alpha greater than 0.80 for all of the four DHTDICS domains in this study. An acceptable validity was confirmed through tests of construct validity, convergent validity and discriminant validity. With respect to the potential domains and dimensions that DHTDICS contributes, the results highlight the existence of 4 domains: personal beliefs, technical drivers, organizational readiness, and external environment. Among them, the impact on health technology diffusion is, in descending order, organizational readiness, personal beliefs, external environment, and technical drivers.Conclusions: The findings of this study support the validity of the DHTDICS, and will be a helpful reference for developing future intervention strategies to promote health technology diffusion in the ICS.
“…Limited diffusion and utilization of health technology has greatly halted the improvement of resource integration and healthcare outcomes [42,43]. This issue has become even more severe and Additionally, as confirmed by previous researches, organizational norms and values controls the way individuals interact with each other within or outside the boundaries of the organization, which also directly impact the health technology diffusion [19,25]. Apart from these factors, domains of technical drivers and external environment are also significant dynamics components that can not be ignored in health technology diffusion in RMC.…”
Section: Discussionmentioning
confidence: 94%
“…Attitude has been perceived as one of the most powerful predictor in technology adoption and use, while subjective norms are kind of perceived criterions and pressures from important individuals' judgements. With respect to DCP test adoption and use, physicians' positive or negative attitude reflects different predispositions [18,19]. And for the physicians working in a clear hierarchy system such as the RMC, opinions on DCP test from leaders, supervisors and colleagues are forces to be reckoned with [20][21][22].…”
Background Limited diffusion and utilization of health technology has greatly halted the improvement of resource integration and healthcare outcomes. However, the dynamic mechanism of health technology diffusion in the context of integrated care system (ICS) remained largely unknown. The purpose of this study was to develop and validate the scale on Dynamics of Health Technology Diffusion in Integrated Care System (DHTDICS) for providing instruments to investigate the health technology diffusion in ICS.Methods The scale was initially designed on the basis of the proposed model developed from previous research. And it was validated in a cross-sectional questionnaire survey. Exploratory factor analysis was used to assess domains in the questionnaire, and analyzed factorials, internal consistency and validity of the questionnaire. Results Reliability analysis revealed excellent internal consistency, as the value of Cronbach’s alpha all greater than 0.80 for four of the domains in this study. An acceptable validity was confirmed through tests of construct validity, convergent validity and discriminant validity. With respect to the potential domains and dimensions that DHTDICS contributes, the results highlight the existence of 4 domains: personal beliefs, technical drivers, organizational readiness and external environment.Conclusions The findings of this study will be capable to serve as a valid instrument to measure health technology diffusion, and be also helpful in developing future intervention strategies to promote the health technology diffusion in ICS.
“…In the past, midwives amongst other care providers have identified these factors as "barriers", such as workplace culture, time constraints, funding and resources and resistance to change (Barwick, 2011;Kennedy, Doig, Hackley, Leslie, & Tillman, 2012). These barriers impinge on clinicians' efforts to adopt new practice or process initiatives (Bayes et al, 2016;Darling, 2016;Geerligs, Rankin, Shepherd, & Butow, 2018;Weir, Newham, Dunlop, & Bennie, 2019). More recently, recognition of other dimensions influential to the implementation process is reported to include individual mindset, knowledge and values of EBP, clinical competence, confidence and collegial collaboration (Mariano et al, 2018).…”
Section: Is Instruments Is the Consolidated Framework For Implementationmentioning
Aims and objectives
To synthesise international research that relates to midwives' use of best available evidence in practice settings and identify key issues relating to the translation of latest evidence into everyday maternity care.
Background
Midwifery is a research‐informed profession. However, a gap persists in the translation of best available evidence into practice settings, compromising gold standard maternity care and delaying the translation of new knowledge into everyday practice.
Design
A five‐step integrative review approach, based on a series of articles published by the Joanna Briggs Institute (JBI) for conducting systematic reviews, was used to facilitate development of a search strategy, selection criteria and quality appraisal process, and the extraction and synthesis of data to inform an integrative review.
Methods
The databases CINAHL, MEDLINE, Web of Science, Implementation Science Journal and Scopus were searched for relevant articles. The screening and quality appraisal process complied with the PRISMA 2009 checklist. Narrative analysis was used to develop sub‐categories and dimensions from the data, which were then synthesised to form two major categories that together answer the review question.
Results
The six articles reviewed report on midwives' use of best available evidence in Australia, the UK and Asia. Two major categories emerged that confirm that although midwifery values evidence‐based practice (EBP), evidence‐informed maternity care is not always employed in clinical settings. Additionally, closure of the evidence‐to‐practice gap in maternity care requires a multidimensional approach.
Conclusion
Collaborative partnerships between midwives and researchers are necessary to initiate strategies that support midwives' efforts to facilitate the timely movement of best available evidence into practice.
Relevance to clinical practice
Understanding midwives' use of best available evidence in practice will direct future efforts towards the development of mechanisms that facilitate the timely uptake of latest evidence by all maternity care providers working in clinical settings.
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