Successful Healthcare Improvements From Translating Evidence in complex systems (SHIFT-Evidence): simple rules to guide practice and research

Abstract

SHIFT-Evidence provides a practical tool to guide practice and research of evidence translation and improvement within complex dynamic healthcare settings. Implications are that improvement initiatives and research study designs need to take into account the unique initial conditions in each local setting; conduct needs to respond to unpredictable effects and address dependent problems; and evaluation needs to be sensitive to evolving priorities and the emergent range of activities required to achieve improvement.

Obtaining information from family caregivers to inform hospital care for people with dementia: A pilot study

“…Moreover, the change leaders were not engaged as stakeholders in the reference group. According to Reed Howe Doyle and Bell (), a strategic principle when engaging in healthcare improvement via evidence translation is to engage with and empower all stakeholders. In future work, including change leaders in the study reference group would help to ensure both their commitment to driving change and the feasibility of that change.…”

The role of patients and carers in diffusing a health‐care innovation: A case study of “My Medication Passport”

“…This necessary and supportive environment helped to enable the diffusion of the MMP innovation and effectively realize the value of patient involvement. The need for this support has been noted previously . Patients and carers described in this study had the benefit of organizational infrastructure, enabling them to co‐design, plan and work together with health‐care professionals on a variety of activities which helped diffuse the MMP innovation.…”

“…The enabling culture shaping the study was important. Reed et al point out, in their assessment of strategic principles, common challenges and simple rules that can guide health‐care improvements, that there is a need to embrace complexity, develop a holistic understanding of the strategic and practical possibilities and, in so doing, engage and empower all who have a role to play in delivering innovation. This study identified key roles played by patients in the diffusion of the MMP innovation: advocate; relationship builder; relationship broker; planner; presenter; awareness raiser; trainer; networker.…”

“…However, we draw attention to this because the roles and qualities are under-recog- The need for this support has been noted previously. [29][30][31] Patients and carers described in this study had the benefit of organizational infrastructure, enabling them to co-design, plan and work together Table 3 and audiences summarized in Table 4 reported that they had not had any previous contact with homeless people, or with some faith groups before building relationships with them to offer, demonstrate and advocate the use of MMP. Opportunities opened up for patients and health-care professionals to access previously untapped audiences.…”

“…It subsequently provided a platform to make the innovation widely available. In addition, it was responsive to new ideas and opportunities, recognizing the need for and supporting innovation in complex health‐care systems . Methodologies shaped by NIHR CLAHRC NWL progressed iterative testing and development of the innovation, encouraging patients and carers to work as part of a service improvement team.…”