Article type
Abstract
Introduction
Health and social care standards are complex interventions that promote safe, high-quality care. Limited evidence exists on implementation strategies to support the implementation of standards. There is a need to apply evidence-based, rigorous, and transparent methods when selecting implementation strategies. Researchers have highlighted a research-to-practice gap in this area. We aimed to develop and test an evidence- and theory-informed intervention to guide the identification and selection of support tools and support actions for use when implementing a set of standards.
Methods
The Medical Research Council framework for developing and evaluating complex interventions and program theory guided a multimethods sequential approach. We conducted a systematic review (n = 35 included studies) and a qualitative exploration (focus groups [n = 6], participants [n = 30], and individual interviews [n = 8]) to identify and describe enablers and barriers to implementing (inter)nationally endorsed standards. We used set criteria to prioritize enablers and barriers. These enablers and barriers were used alongside implementation science theory, tools, and methodologies to develop a digital intervention. The Consolidated Framework for Implementation Research (CFIR), CFIR-ERIC (Expert Recommendations for Implementing Change) matching tool, and the Behaviour Change Wheel were used to develop a prototype of the content and interactive logic within a digital intervention. Codesign workshops (n = 3) were held to refine the intervention with intended users (n = 7). Feasibility testing was undertaken with end users (n = 14) using a survey to estimate acceptability and feasibility.
Results
Key enablers identified were education, teamwork, and shared learning. Key barriers were workforce issues and a lack of knowledge of standards. Twenty-three enablers and barriers were prioritized. Iterative feedback from workshops led to refinements of the intervention, creating the prototype for feasibility testing. The intervention was entitled SITAS (Selecting Implementation Tools and Actions for Standards). SITAS was perceived as acceptable and feasible in preliminary testing.
Conclusion
We developed a feasible intervention, enhanced by user involvement. SITAS is a practical digitally enabled intervention that can facilitate bridging the research-to-practice gap. SITAS aims to guide the process of selecting and tailoring implementation strategies to specific contexts, using core concepts of implementation science. Further research is required to undertake formal piloting of SITAS before spread and scale-up.
Health and social care standards are complex interventions that promote safe, high-quality care. Limited evidence exists on implementation strategies to support the implementation of standards. There is a need to apply evidence-based, rigorous, and transparent methods when selecting implementation strategies. Researchers have highlighted a research-to-practice gap in this area. We aimed to develop and test an evidence- and theory-informed intervention to guide the identification and selection of support tools and support actions for use when implementing a set of standards.
Methods
The Medical Research Council framework for developing and evaluating complex interventions and program theory guided a multimethods sequential approach. We conducted a systematic review (n = 35 included studies) and a qualitative exploration (focus groups [n = 6], participants [n = 30], and individual interviews [n = 8]) to identify and describe enablers and barriers to implementing (inter)nationally endorsed standards. We used set criteria to prioritize enablers and barriers. These enablers and barriers were used alongside implementation science theory, tools, and methodologies to develop a digital intervention. The Consolidated Framework for Implementation Research (CFIR), CFIR-ERIC (Expert Recommendations for Implementing Change) matching tool, and the Behaviour Change Wheel were used to develop a prototype of the content and interactive logic within a digital intervention. Codesign workshops (n = 3) were held to refine the intervention with intended users (n = 7). Feasibility testing was undertaken with end users (n = 14) using a survey to estimate acceptability and feasibility.
Results
Key enablers identified were education, teamwork, and shared learning. Key barriers were workforce issues and a lack of knowledge of standards. Twenty-three enablers and barriers were prioritized. Iterative feedback from workshops led to refinements of the intervention, creating the prototype for feasibility testing. The intervention was entitled SITAS (Selecting Implementation Tools and Actions for Standards). SITAS was perceived as acceptable and feasible in preliminary testing.
Conclusion
We developed a feasible intervention, enhanced by user involvement. SITAS is a practical digitally enabled intervention that can facilitate bridging the research-to-practice gap. SITAS aims to guide the process of selecting and tailoring implementation strategies to specific contexts, using core concepts of implementation science. Further research is required to undertake formal piloting of SITAS before spread and scale-up.