Understanding clinical implementation coordinators' experiences in deploying evidence-based interventions.

Autor:	Hernandez SE; School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA., Solomon D; Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, WI, USA., Moon J; School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA., Parmasad V; School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA., Wiegmann D; Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, WI, USA., Bennett NT; Antimicrobial Stewardship Program, Saint Luke's Health System, Kansas City, MO, USA., Ferren RS; University of Texas Medical Branch, Galveston, TX, USA., Fitzsimmons AJ; Department of Medical Research, Gundersen Health System, La Crosse, WI, USA., Lepak AJ; School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA., O'Horo JC; Mayo Foundation for Medical Education and Research, Rochester, MN, USA., Pop-Vicas AE; School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA., Schulz LT; Department of Pharmacy, University of Wisconsin Health, Madison, WI, USA., Safdar N; School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.
Jazyk:	angličtina
Zdroj:	American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists [Am J Health Syst Pharm] 2024 Feb 08; Vol. 81 (4), pp. 120-128.
DOI:	10.1093/ajhp/zxad272
Abstrakt:	Purpose: The fluoroquinolone restriction for the prevention of Clostridioides difficile infection (FIRST) trial is a multisite clinical study in which sites carry out a preauthorization process via electronic health record-based best-practice alert (BPA) to optimize the use of fluoroquinolone antibiotics in acute care settings. Our research team worked closely with clinical implementation coordinators to facilitate the dissemination and implementation of this evidence-based intervention. Clinical implementation coordinators within the antibiotic stewardship team (AST) played a pivotal role in the implementation process; however, considerable research is needed to further understand their role. In this study, we aimed to (1) describe the roles and responsibilities of clinical implementation coordinators within ASTs and (2) identify facilitators and barriers coordinators experienced within the implementation process. Methods: We conducted a directed content analysis of semistructured interviews, implementation diaries, and check-in meetings utilizing the conceptual framework of middle managers' roles in innovation implementation in healthcare from Urquhart et al. Results: Clinical implementation coordinators performed a variety of roles vital to the implementation's success, including gathering and compiling information for BPA design, preparing staff, organizing meetings, connecting relevant stakeholders, evaluating clinical efficacy, and participating in the innovation as clinicians. Coordinators identified organizational staffing models and COVID-19 interruptions as the main barriers. Facilitators included AST empowerment, positive relationships with staff and oversight/governance committees, and using diverse implementation strategies. Conclusion: When implementing healthcare innovations, clinical implementation coordinators facilitated the implementation process through their roles and responsibilities and acted as strategic partners in improving the adoption and sustainability of a fluoroquinolone preauthorization protocol. (© American Society of Health-System Pharmacists 2023. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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