Tracking implementation strategies: a description of a practical approach and early findings
| Autor: | Hillary A. Robertson, Sarah A. Birken, Alicia C. Bunger, Christopher M. Shea, Hannah MacDowell, Byron J. Powell |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Process management
Quality management Computer science Context (language use) Bioinformatics Outcome (game theory) 03 medical and health sciences Consistency (database systems) 0302 clinical medicine Methods Humans 030212 general & internal medicine Prospective Studies Duration (project management) Program Development Retrospective Studies Measurement 030503 health policy & services Health Policy Research Data Collection Health services research Level of detail (writing) 16. Peace & justice Organizational Innovation Research Personnel Group Processes Identification (information) Leadership Reporting 13. Climate action Diffusion of Innovation 0305 other medical science Implementation strategies |
| Zdroj: | Health Research Policy and Systems |
| ISSN: | 1478-4505 |
| Popis: | Background Published descriptions of implementation strategies often lack precision and consistency, limiting replicability and slowing accumulation of knowledge. Recent publication guidelines for implementation strategies call for improved description of the activities, dose, rationale and expected outcome(s) of strategies. However, capturing implementation strategies with this level of detail can be challenging, as responsibility for implementation is often diffuse and strategies may be flexibly applied as barriers and challenges emerge. We describe and demonstrate the development and application of a practical approach to identifying implementation strategies used in research and practice that could be used to guide their description and specification. Methods An approach to tracking implementation strategies using activity logs completed by project personnel was developed to facilitate identification of discrete strategies. This approach was piloted in the context of a multi-component project to improve children’s access to behavioural health services in a county-based child welfare agency. Key project personnel completed monthly activity logs that gathered data on strategies used over 17 months. Logs collected information about implementation activities, intent, duration and individuals involved. Using a consensus approach, two sets of coders categorised each activity based upon Powell et al.’s (Med Care Res Rev 69:123–57, 2012) taxonomy of implementation strategies. Results Participants reported on 473 activities, which represent 45 unique strategies. Initial implementation was characterised by planning strategies followed by educational strategies. After project launch, quality management strategies predominated, suggesting a progression of implementation over time. Together, these strategies accounted for 1594 person-hours, many of which were reported by the leadership team that was responsible for project design, implementation and oversight. Conclusions This approach allows for identifying discrete implementation strategies used over time, estimating dose, describing temporal ordering of implementation strategies, and pinpointing the major implementation actors. This detail could facilitate clear reporting of a full range of implementation strategies, including those that may be less observable. This approach could lead to a more nuanced understanding of what it takes to implement different innovations, the types of strategies that are most useful during specific phases of implementation, and how implementation strategies need to be adaptively applied throughout the course of a given initiative. Electronic supplementary material The online version of this article (doi:10.1186/s12961-017-0175-y) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|