Tool for evaluating research implementation challenges: a sense-making protocol for addressing implementation challenges in complex research settings

Autor: Ruth A. Anderson, Kathryn Daily, Alyson Stalzer, Kristie Porter, Cathleen S. Colón-Emeric, Kelly M. Simpson, Eleanor S. McConnell
Rok vydání: 2012
Předmět:
Comparative Effectiveness Research
Process management
Inservice Training
Pilot Projects
Health informatics
0302 clinical medicine
Clinical Protocols
Medicine
030212 general & internal medicine
Staff intervention
Intervention research
media_common
Medicine(all)
Evidence-Based Medicine
030503 health policy & services
Health Policy
Health services research
General Medicine
Quality Improvement
Organizational Innovation
Complexity science
Research design
Evaluation Studies as Topic
0305 other medical science
Algorithms
Implementation research
Process (engineering)
media_common.quotation_subject
Comparative effectiveness research
Decision Making
Fidelity
Nursing homes
Health Informatics
03 medical and health sciences
Long-term care
Nursing
Humans
Sense-making
Protocol (science)
business.industry
Public Health
Environmental and Occupational Health
Methodology
Group Processes
Systematic process
Accidental Falls
Nursing Staff
Diffusion of Innovation
Research fidelity
business
Zdroj: Implementation Science : IS
ISSN: 1748-5908
Popis: Background Many challenges arise in complex organizational interventions that threaten research integrity. This article describes a T ool for E valuating Research Implementation Ch allenges (TECH), developed using a complexity science framework to assist research teams in assessing and managing these challenges. Methods During the implementation of a multi-site, randomized controlled trial (RCT) of organizational interventions to reduce resident falls in eight nursing homes, we inductively developed, and later codified the TECH. The TECH was developed through processes that emerged from interactions among research team members and nursing home staff participants, including a purposive use of complexity science principles. Results The TECH provided a structure to assess challenges systematically, consider their potential impact on intervention feasibility and fidelity, and determine actions to take. We codified the process into an algorithm that can be adopted or adapted for other research projects. We present selected examples of the use of the TECH that are relevant to many complex interventions. Conclusions Complexity theory provides a useful lens through which research procedures can be developed to address implementation challenges that emerge from complex organizations and research designs. Sense-making is a group process in which diverse members interpret challenges when available information is ambiguous; the groups’ interpretations provide cues for taking action. Sense-making facilitates the creation of safe environments for generating innovative solutions that balance research integrity and practical issues. The challenges encountered during implementation of complex interventions are often unpredictable; however, adoption of a systematic process will allow investigators to address them in a consistent yet flexible manner, protecting fidelity. Research integrity is also protected by allowing for appropriate adaptations to intervention protocols that preserve the feasibility of ‘real world’ interventions.
Databáze: OpenAIRE
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