Provision of Defect-Free Care

Lasinski, Alaina M; Ladha, Prerna; Ho, Vanessa P.

doi:10.1016/j.suc.2020.09.009

Cited by 4 publications

(2 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As surgical interventions strive to improve care for older and more complex patients, their implementation warrants systematic evaluation; however, studies using theoretical frameworks to examine surgical interventions are limited. [11][12][13][14] The Consolidated Framework for Implementation Research (CFIR) has been applied across various settings, most commonly healthcare systems, and organizes findings across five domains: intervention characteristics, outer setting or external influences, inner setting or organizational factors, characteristics of individuals performing intervention, and process of planning and delivering intervention. 15,16 Within each domain, findings are further categorized by theory-based constructs associated with effective implementation.…”

Section: Key Pointsmentioning

confidence: 99%

Evaluation of interdisciplinary care pathway implementation in older elective surgery patients

Rowe

O'Mara

et al. 2023

J American Geriatrics Society

View full text Add to dashboard Cite

Background The American College of Surgeons Geriatric Surgery Verification Program outlines best practices for surgical care in older adults. These recommendations have guided institutions to create workflows to better support needs specific to older surgical patients. This qualitative study explored clinician experiences to understand influences on implementation of frailty screening and an interdisciplinary care pathway in older elective colorectal surgery and neurosurgery patients. Study Design Semi‐structured in‐person and video‐based interviews were conducted from July 2021 to March 2022 with clinicians caring for patients ≥70 years on the colorectal surgery and neurosurgery services. Interviews addressed familiarity with and beliefs about the intervention, intervention alignment with routine workflow and workflow adaptations, and barriers and facilitators to performing the intervention. Interviews were analyzed using the consolidated framework for implementation research (CFIR) to find themes related to ongoing implementation. Results Thirty‐two clinicians participated (56.3% female, 58.8% White). Fifteen relevant CFIR constructs were identified. Key themes to implementation success included strong participant belief in effectiveness of the intervention and its advantage over standard care; the importance of training, reference materials, and champions; and the need for institution‐level investment in resources to amplify the impact of the intervention on patients and expand the capacity to address their needs. Conclusion Systematic evaluation found implementation of frailty screening and an interdisciplinary care pathway in elective colorectal surgery and neurosurgery patients to be supported by participating clinicians, yet sustainability of the intervention and further adoption across surgical services to better meet the needs of older patients would necessitate organizational resource allocation.

show abstract

Section: Key Pointsmentioning

confidence: 99%

Evaluation of interdisciplinary care pathway implementation in older elective surgery patients

Rowe

O'Mara

et al. 2023

J American Geriatrics Society

View full text Add to dashboard Cite

show abstract

“…Implementation science is increasingly gaining credence as a revolution in healthcare, partly because it is being recognised as the thing that-makes-the-thing happen, but also offers answers to why it (very often) does not happen. The result is a proliferation of applied studies, particularly in healthcare (124)(125)(126)(127), but also in education (128)(129)(130)(131).…”

Section: Implementation Practicementioning

confidence: 99%

A Framework for Implementing National Respiratory Guidelines in Wales

Jefferies

View full text Add to dashboard Cite

Introduction: Implementation outcomes are necessary to experience clinical impact of interventions in the real world. Clear synergy exists between evidence-based clinical recommendations in clinical guidelines and the evidence-based process of implementing them, however less than a quarter of clinical guidelines are implemented using a framework. Methods: Critical review and analysis of the published literature provided the basis for developing framework constructs to facilitate the process of implementing national clinical guidelines in Wales. This is an observational assessment using mixed methods to assess the acceptability and adoption of novel national clinical guidelines in Wales. The framework is adapted in preparation for formal validation. Results: A conceptual framework for implementing clinical guidelines at scale was developed from the literature and findings from thematic analysis of potential guideline adopters in Wales. This was deemed relevant to wider strategies and was therefore applied to the implementation of novel asthma/COPD and COVID-19 guidelines. Applying the framework demonstrated widespread acceptance and adoption of the guidelines across all Health Boards in NHS Wales, however evidence of widespread adherence of the guidelines with fidelity remains unproven as this requires longitudinal observation of process and clinical outcome benefits relating to each guideline recommendations. Conclusions: The differentiation of contexts between the two case studies presented here highlights the difference in pace and urgency of implementation to optimise penetration of a guideline 23 implementation strategy across a target population in Wales. It addresses much of the ambiguity of definitions and joins common principles to create a framework that can be recommended for further testing with other clinical specialities and contexts outside of Wales. Whilst the COVID-19 pandemic introduced a major barrier to guideline adoption for asthma and COPD, it also presented a unique scenario that stimulated large-scale use of a novel COVID guideline. Whilst it was too soon to explore the correlation between implementation strategies, guideline adherence, and clinical outcomes – achieving acceptance and adoption of the guidelines lays the foundations for further exploration of social benefits on a national scale.

show abstract

Application of dissemination and implementation science frameworks to surgical research

Hakimi

Vavra

2022

Seminars in Vascular Surgery

View full text Add to dashboard Cite

Provision of Defect-Free Care

Cited by 4 publications

References 38 publications

Evaluation of interdisciplinary care pathway implementation in older elective surgery patients

Evaluation of interdisciplinary care pathway implementation in older elective surgery patients

A Framework for Implementing National Respiratory Guidelines in Wales

Application of dissemination and implementation science frameworks to surgical research

Contact Info

Product

Resources

About