Introduction

Pronovost, Gilles; Lacharité, Carl

doi:10.2307/j.ctv18pghxc.5

Cited by 2 publications

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“…Where this was needed, there was an expectation among participants in primary care practices that if capital expenditure is needed in implementation of an innovation, improvement or EBP this should be partly or fully met by government as it is not covered in the fees practices receive as part of their contract to deliver services. Examples of Cross Reference or Support in Literature: , (Colquhoun et al 2010), (Davies et al 2010), (Liang et al 2017) (Powell et al 2014), ( Grol et al , 2007, (Mendel et al 2008), , (Estabrooks 2006, (Pronovost 2008)…”

Section: Implementation Of Innovation Improvement and Ebp In Primary ...mentioning

confidence: 99%

“…Examples of Cross Reference or Support in Literature: , Greenhalgh (2004), Rogers (2003), , Pronovost (2008), Features of Literature and Data Collected Relevant to Developing a Framework of Implementation of Innovation, Improvement and EBP in Primary Care:…”

Section: P8 P2 P12 P10mentioning

confidence: 99%

“…The literature said this concept was an important part of translating evidence-based practice into operational use (Pronovost, 2008), who said engagement was about inspiring stakeholders to support the outcomes. They did this by "sharing real life stories of patient tragedies and triumphs and by estimating the harm attributable to omitting the intervention in their unit or hospital given their baseline data" (Pronovost, 2008). proposed four specific methods of engagement: using opinion leaders, formally appointed implementation leaders, change champions and external change agents.…”

Section: Motivationmentioning

confidence: 99%

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Implementing Innovation, Improvement and Evidence-Based Practice in Service Delivery: A Model for the Primary Care Sector in NHS Wales

O’Brien¹

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The British NHS has continuously innovated since its inception almost 75 years ago.Innovations come in many forms and range from process innovations to advances in technology and digital enablers, which have radically changed professional practice. There are also a large volume and wide range of managerial improvement programmes and significant levels of evidence-based practice as well as clinical research. The challenge lies in determining how best to implement these innovations into existing systems so that their potential can be realised.Throughout all of these years, the locus of research activity has been on secondary care and specialist innovations. This bias has favoured clinical and professional groups who operate in highly specialised and distinctive areas of health and care provision. The majority of NHS activity, however, occurs in primary care where there is less specialisation and organisations tend to be smaller. With more limited financial resources, general practices face significant challenges in their attempts to embrace the latest innovations for the benefit of patients and local communities. This research addresses the determinants (enablers and inhibitors) that relate to the adoption of innovation by primary care organisations, building theory and redressing the imbalance in research activities.While some models of implementation already exist, they have been drawn from the field of secondary care. Having exposed a gap, this research responds by developing a framework that specifically focuses on the implementation of innovation, improvement and evidence based practice (known as ‘EBP’) in primary care.The study takes a realist pragmatic approach to understanding the enablers and inhibitors of the implementation of innovation, improvement and EBP into primary care. The research has been conducted by means of several distinct phases. This includes an initial conceptual model, drawn from a review of the existing academic literature, followed by a qualitative phase of expert interviews with purposively selected informants as well as the development of an empirical model. The researcher also created a questionnaire which was sent to experts from various parts of the Welsh NHS innovation ecosystem. The research study contributes much to our understanding of innovation in primary care and has resulted in a final and tested model of the innovation, improvement and EBP implementation that is in operation in Wales. The research finds many failings in the current system, which are preventing the seamless migration of promising innovations and advances in care into the primary care sector. These inhibitors include a lack of trust between the actors within the system, the imposition of national directives – without any form of support to the general practices – and a lack of competence in the form of variable staff competence in general practitioners’ surgeries.The research concludes that the determinants identified and the poor levels of trust and joint participation between providers, commissioners and government are preventing a collaborative systems approach. Primary care in the Welsh NHS, therefore, is currently unable – as a system – to create a critical mass of general practices that all use similar and interoperable innovations. Without such sharing of innovation, improvement and EBP, and without addressing the way in which the stakeholders of the Welsh NHS interact, it is unlikely that meaningful progress will be made across all general practices in Wales.

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Section: Implementation Of Innovation Improvement and Ebp In Primary ...mentioning

confidence: 99%

Section: P8 P2 P12 P10mentioning

confidence: 99%

Section: Motivationmentioning

confidence: 99%

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Implementing Innovation, Improvement and Evidence-Based Practice in Service Delivery: A Model for the Primary Care Sector in NHS Wales

O’Brien¹

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Relations parents immigrants-écoles dans l’espace montréalais : au-delà des tensions, la rencontre des rêves 1

Benoît

Rousseau

Ngirumpatse

et al. 2009

rse

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La récente controverse autour des accommodements raisonnables met en relief les enjeux identitaires, dans les écoles qui desservent une clientèle de plus en plus pluriethnique. La création des liens parents immigrants-écoles, essentielle et souhaitée, est modulée par des tensions sociales et politiques et représente un défi parfois difficile à relever. Cet article rapporte les résultats de groupes de discussion avec des parents et des enseignants dans deux écoles montréalaises, dans le but de documenter la relation parents immigrants-écoles. S’inspirant des recommandations formulées par les participants, la discussion offre des pistes pour repenser les échanges entre les parents et la communauté afin de générer des domaines de compréhension partagée.The recent controversy over reasonable accommodation has underscored identity issues in the increasingly multiethnic student population of Montreal schools. While the establishment of good relations between immigrant parents and schools is essential and to be encouraged, it is subject to sociopolitical tensions and represents a sometimes daunting challenge. In this article, the results of parent-teacher focus groups that were organized in two Montreal schools to collect data on these relations are presented. Building on recommendations made by parents and teachers, the article suggests avenues for rethinking interaction between parents and the community as a way of laying the groundwork for mutual understanding.La reciente controversia alrededor de los acomodamientos razonables hace resaltar los retos identitarios en las escuelas que atienden a una clientela cada vez más multiétnica. La creación de los vínculos padres inmigrantes - escuelas, esencial y deseada, está modulada por tensiones sociales y políticas y representa un desafío a veces difícil de enfrentar. Este artículo presenta los resultados de unos grupos de discusión con padres y maestros en dos escuelas de Montreal, con el propósito de documentar la relación padres inmigrantes - escuelas. Inspirándose de las recomendaciones formuladas por los participantes, la discusión ofrece pistas para repensar los intercambios entre los padres y la comunicad, con la finalidad de generar dominios de comprensión compartida

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Introduction

Cited by 2 publications

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Implementing Innovation, Improvement and Evidence-Based Practice in Service Delivery: A Model for the Primary Care Sector in NHS Wales

Implementing Innovation, Improvement and Evidence-Based Practice in Service Delivery: A Model for the Primary Care Sector in NHS Wales

Relations parents immigrants-écoles dans l’espace montréalais : au-delà des tensions, la rencontre des rêves 1

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