What we know about designing an effective improvement intervention (but too often fail to put into practice)

Marshall, Martin; Silva, Debra de; Cruickshank, Lesley; Shand, Jenny; Wei, Li; Anderson, James M.

doi:10.1136/bmjqs-2016-006143

Cited by 65 publications

(67 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Leadership, care home culture, and staff capacity to engage in and prioritise innovations are well recognised as important influences on uptake of innovation [82,83]. Given this, it is disappointing that, in many studies, these well-documented challenges are presented as findings, rather than being used to inform the study design.…”

Section: Discussionmentioning

confidence: 99%

“…This study found that service integration between the NHS and care homes was dependent on time, and support from commissioners to develop relational working. It is also suggested that a long preparatory period, consultation with a range of frontline staff and care home residents [83], and co-design of interventions could improve implementation [85].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Setting Priorities to Inform Assessment of Care Homes’ Readiness to Participate in Healthcare Innovation: A Systematic Mapping Review and Consensus Process

Bunn

Goodman

Corazzini

et al. 2020

IJERPH

View full text Add to dashboard Cite

Organisational context is known to impact on the successful implementation of healthcare initiatives in care homes. We undertook a systematic mapping review to examine whether researchers have considered organisational context when planning, conducting, and reporting the implementation of healthcare innovations in care homes. Review data were mapped against the Alberta Context Tool, which was designed to assess organizational context in care homes. The review included 56 papers. No studies involved a systematic assessment of organisational context prior to implementation, but many provided post hoc explanations of how organisational context affected the success or otherwise of the innovation. Factors identified to explain a lack of success included poor senior staff engagement, non-alignment with care home culture, limited staff capacity to engage, and low levels of participation from health professionals such as general practitioners (GPs). Thirty-five stakeholders participated in workshops to discuss findings and develop questions for assessing care home readiness to participate in innovations. Ten questions were developed to initiate conversations between innovators and care home staff to support research and implementation. This framework can help researchers initiate discussions about health-related innovation. This will begin to address the gap between implementation theory and practice.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Setting Priorities to Inform Assessment of Care Homes’ Readiness to Participate in Healthcare Innovation: A Systematic Mapping Review and Consensus Process

Bunn

Goodman

Corazzini

et al. 2020

IJERPH

View full text Add to dashboard Cite

show abstract

“…MaPSaF was one component of a complex socio-technical safety improvement intervention which was co-designed by the improvement and evaluation teams, the other components being training in quality improvement methods and the measurement and benchmarking of the prevalence of the target safety incidents 23. All three components were underpinned by a strong emphasis on support, facilitation and shared learning, provided or coordinated by members of the local government improvement team in partnership with the local health service.…”

Section: Methodsmentioning

confidence: 99%

Assessing the safety culture of care homes: a multimethod evaluation of the adaptation, face validity and feasibility of the Manchester Patient Safety Framework

Marshall

Cruickshank

Shand³

et al. 2017

BMJ Qual Saf

Self Cite

View full text Add to dashboard Cite

Background Understanding the cultural characteristics of healthcare organisations is widely recognised to be an important component of patient safety. A growing number of vulnerable older people are living in care homes but little attention has been paid to safety culture in this sector. In this study we aimed to adapt the Manchester Patient Safety Framework (MaPSaF), a commonly used tool in the health sector, for use in care homes and then to test its face validity and preliminary feasibility as a tool for developing a better understanding of safety culture in the sector.Methods As part of a wider improvement programme to reduce the prevalence of falls, pressure ulcers and urinary tract infections amongst residents in 90 care homes in England, we carried out a multi-method participatory evaluation of the adaptation of MaPSaF and its face validity and feasibility for care home staff. Data were collected using participant observation, interviews, documentary anlaysis and a survey, and were analysed thematically.Results MapSaf required considerable adaptation in terms of its length, language and content in order for it to be perceived to be acceptable and useful to care home staff. The changes reflected differences between the health and care home sectors in terms of the local context and wider policy environment, and the expectations, capacity and capabilities of the staff.Conclusions A new tool, named 'Culture is Key' was developed and has the potential to be used more widely in care homes to address deficiencies in resident care by deepening staff understanding of the safety culture of their organisations. words

show abstract

“…Though it has yet to be considered within KT, intersectionality offers a nuanced and comprehensive account of context, and uniquely and importantly can be used to consider how these factors intersect to shape individual decision-making and behaviour. Accounting for the diverse intersections of individuals' lived experiences has the potential to increase the effectiveness and generalizability of interventions and enhance their sociological fidelity [19,20].…”

Section: Introductionmentioning

confidence: 99%

Applying an intersectionality lens to the Theoretical Domains Framework: a tool for thinking about how intersecting social identities and structures of power influence behaviour

Etherington

Rodrigues

Giangregorio

et al. 2020

Preprint

View full text Add to dashboard Cite

Background A key component of the implementation process is identifying potential barriers and facilitators that need to be addressed. The Theoretical Domains Framework (TDF) is one of the most commonly used frameworks for this purpose. When applying the TDF, it is critical to understand the context in which behaviours occur. Intersectionality, which accounts for the interface between social identity factors and structures of power, offers a novel approach to understanding how context shapes individual decision-making and behaviour. We aimed to develop a tool to be used alongside applications of the TDF to incorporate an intersectionality lens when identifying implementation barriers and enablers. Methods An interdisciplinary Framework Committee (n=17) prioritized the TDF as one of three models, theories, and frameworks (MTFs) to enhance with an intersectional lens through a modified Delphi approach. The modified Delphi involved two rounds of online voting followed by a final majority vote. In collaboration with the wider Framework Committee, a subgroup considered all 14 TDF domains and iteratively developed recommendations for incorporating intersectionality considerations within the and its domains TDF. An iterative approach aimed at building consensus was used to finalize recommendations. Results Consensus on how to apply an intersectionality lens to the TDF was achieved after 12 rounds of revision. Two overarching considerations for using the intersectionality-enhanced TDF were developed by the group as well as two to four prompts for each TDF domain to guide interview topic guides. Conclusions Through an expert-consensus approach, we developed a tool for applying an intersectionality lens alongside the TDF. By considering the role of intersecting social factors when selecting, tailoring, and implementing KT interventions, they may become more effective.

show abstract

What we know about designing an effective improvement intervention (but too often fail to put into practice)

Cited by 65 publications

References 19 publications

Setting Priorities to Inform Assessment of Care Homes’ Readiness to Participate in Healthcare Innovation: A Systematic Mapping Review and Consensus Process

Setting Priorities to Inform Assessment of Care Homes’ Readiness to Participate in Healthcare Innovation: A Systematic Mapping Review and Consensus Process

Assessing the safety culture of care homes: a multimethod evaluation of the adaptation, face validity and feasibility of the Manchester Patient Safety Framework

Applying an intersectionality lens to the Theoretical Domains Framework: a tool for thinking about how intersecting social identities and structures of power influence behaviour

Contact Info

Product

Resources

About