2015
DOI: 10.1186/s13012-014-0198-5
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Improving the implementation of perioperative safety guidelines using a multifaceted intervention approach: protocol of the IMPROVE study, a stepped wedge cluster randomized trial

Abstract: BackgroundThis study is initiated to evaluate the effects, costs, and feasibility at the hospital and patient level of an evidence-based strategy to improve the use of Dutch perioperative safety guidelines. Based on current knowledge, expert opinions and expertise of the project team, a multifaceted implementation strategy has been developed.Methods/designThis is a stepped wedge cluster randomized trial including nine representative hospitals across The Netherlands. Hospitals are stratified into three groups a… Show more

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Cited by 16 publications
(21 citation statements)
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References 35 publications
(32 reference statements)
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“…A systematic review of the literature by Hakkennes and Dodd suggested that simply adding more implementation strategies does not improve the uptake of a guideline. Additionally, many other studies have reported that combined strategies are only more effective than a single intervention if they address the barriers related to professional performance …”
Section: Discussionmentioning
confidence: 99%
“…A systematic review of the literature by Hakkennes and Dodd suggested that simply adding more implementation strategies does not improve the uptake of a guideline. Additionally, many other studies have reported that combined strategies are only more effective than a single intervention if they address the barriers related to professional performance …”
Section: Discussionmentioning
confidence: 99%
“…The study team estimated that the intracluster correlation (ICC) would be 0.1 based on previous studies that have reported ICC for interventions to improve guideline adherence among physicians. [29][30][31] Given the fixed number of attending physicians employed at the study setting, the team planned 6 clusters in order to best balance study groups. Using these assumptions, the team estimated the design effect to be 2.63, resulting in a total required sample size of 915 to detect a 15% increase in adherence to clinical practice guidelines.…”
Section: Discussionmentioning
confidence: 99%
“…The implementation strategy and the intervention, however, may need to be adapted if they are to fit within the routines of local practice 86. Adaptation is the degree to which the strategy and intervention are modified by users during implementation to suit local needs 26. Insufficient fidelity to the ‘active ingredients’ of an intervention dilutes effectiveness,87 whereas insufficient adaptation stifles tailoring potentially diluting effective implementation 88.…”
Section: Elaboration On Individual Checklist Itemsmentioning
confidence: 99%