DOI: 10.1097/01.pcc.0000449636.80539.2f
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Issn Print: 1529-7535
Publication Date: 2014/05/01
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Excerpt
Aims: We evaluated the implementations of a complex inter-professional intervention in acute hospital settings to describe differences in approach and the relative impact on innovation adoption.
Methods: A prospective observational study of 4 international hospitals implementing the BedsidePEWS innovation was performed. Two implementation team members completed a qualitative review of data obtained from audiotapes and notes of weekly meetings with each hospital team. Thematic analysis identified common domains in implementation approaches. These domains were validated with the site teams and grouped into the PHARIS framework (evidence, facilitation, and context) for further analysis.
Results: Data was synthesized from 109 hour-long meetings (22-34 per team). Three implementation domains were identified along with seven domain –specific items; socially embeded process (front line engagement, use of champions), organizational level influences (audit and feedback, motivation for organizational change, implementation team characteristics) and fit of the innovation (customization, education).
In the domains of social process and innovation fit we found that implementation items manifested across a continuum of influence from facilitator to barrier. Organization influences for change were primarily internally driven across all sites. The composition of implementation teams differed between sites as being either research or clinically situated.
Conclusions: Future quantification of these items for evaluation of relationships and the relative importance of each to innovation adoption is planned.
