scholarly journals PROMPT Wales project: national scaling of an evidence-based intervention to improve safety and training in maternity

2021 ◽  
Vol 10 (4) ◽  
pp. e001280
Author(s):  
Sophie Renwick ◽  
Sarah Hookes ◽  
Tim Draycott ◽  
Madhuchanda Dey ◽  
Frances Hodge ◽  
...  
Keyword(s):  
Professional Training ◽  
Large Scale ◽  
Complex Interventions ◽  
Readiness For Change ◽  
Successful Implementation ◽  
Evidence Based ◽  
Implementation Support ◽  
Process Measures ◽  
Implementation Team ◽  
National Implementation

BackgroundIn healthcare, there is increasing recognition of the importance of developing and testing strategies to scale effective interventions. The NHS long-term plan (2019) acknowledges that often a gold standard approach to a problem already exists somewhere within the NHS, however, it has not been replicated widely across the system.MethodsWe describe the approach and process measures for national scaling of PROMPT (Practical Obstetric Multi-Professional Training) across 12 obstetric-led maternity units in Wales. PROMPT is an evidence-based training package for local maternity staff, previously associated with improvements in maternal and neonatal outcomes, reduction in litigation related to preventable harm and improved safety culture. PROMPT has previously been disseminated internationally using a train-the-trainer model. However, this has been associated with variations in uptake, fidelity and impact. In Wales, the project was supported by Welsh Government, and a structured scaling plan was developed, encompassing ongoing implementation support from a multi-professional team.ResultsPROMPT was successfully implemented in all obstetric led units in Wales, with 326 local PROMPT facilitators trained, and 82.5%–100% of maternity staff attended a local PROMPT course in the first 15 months of the project (January 2019–March 2020). All training courses included evidence-based authentic elements, and 93% of courses in the first year (100/107) were supported by a national implementation team, providing coaching, implementation support and quality assurance.ConclusionsAuthentically scaling up complex interventions is a significant challenge. To replicate the improved outcomes demonstrated by PROMPT, intervention reach and fidelity must first be demonstrated.In this national scaling project, our scaling methodology led to the successful implementation of PROMPT across all health boards in Wales. Additionally, we demonstrated reduced variation in adoption, reach, timescale and intervention fidelity between maternity units with varying readiness for change, which had been difficult in two previous large-scale PROMPT implementation projects.

Desired Attributes and Skills of Program Managers in Translation of Evidence-Based Interventions

2011 ◽  
Vol 12 (6_suppl_1) ◽  
pp. 82S-90S ◽  
Author(s):  
Rhonda Williams ◽  
Carol Woodell ◽  
Erin McCarville ◽  
Maureen Damitz ◽  
Tinesha Banks ◽  
...  
Keyword(s):  
Community Health ◽  
Large Scale ◽  
Successful Implementation ◽  
Evidence Based ◽  
Program Manager ◽  
Health Leadership ◽  
Key Skills ◽  
Skill Building ◽  
Public Health Leadership ◽  
Improve Patient

Successful chronic disease project management, especially of multiyear initiatives using evidence-based interventions (EBIs), is of great importance to funders, health care decision makers, and researchers, particularly in light of limited funding. However, a gap in knowledge may exist regarding which attributes and skills are most desirable in a program manager to help him or her ensure successful implementation of EBIs. Although some literature examines the dynamics contributing to the success of community coalitions, public health leadership, and community health education, there is minimal literature exploring the significance of a program manager’s role in the conceptualization, implementation, and sustainability of initiatives to improve patient and community health. The authors present their experiences as participants in a large-scale asthma initiative implemented in priority communities, as well as results of a survey distributed among all personnel of the program sites. The survey aimed to assess the key skills and attributes, in addition to contextual factors, that contribute to the strength of a program manager overseeing EBIs in asthma initiatives. The results suggest that certain attributes and skills are desirable in recruiting and hiring of a program manager, especially when augmented by ongoing skill-building training, and can help ensure program and research success.

scholarly journals The Winding Road to Evidence-Based Policy in Corrections: A Case Study of the Israel Prison Service

2018 ◽  
Vol 51 (1) ◽  
pp. 111-125
Author(s):  
David Weisburd ◽  
Badi Hasisi
Keyword(s):  
Criminal Justice ◽  
Large Scale ◽  
Research Programme ◽  
Successful Implementation ◽  
Evidence Based ◽  
Stages Of Development ◽  
The Road ◽  
Evidence Based Policy ◽  
Key Factor

There has been a growing trend in recent years towards the adoption of evidence-based policy in a variety of fields, including criminal justice. The purpose of evidence-based policy is to guide the activities of organisations based on scientifically verified facts, enabling the development of effective and efficient policies. In this article, we introduce the commitment of the Israel Prison Service (IPS) to the implementation of evidence-based policy by detailing the processes and development of a large-scale research programme in the IPS. We illustrate how the cooperation and commitment of key individuals, including successive IPS Commissioners, have enabled the implementation of evidence-based policy in a hierarchal organisation. Within this context, we demonstrate how human agency is a key factor in the successful implementation of the policy in criminal justice settings. By following the different stages of development and implementation, the example of the IPS also highlights the importance of agencies taking ownership of science. We conclude by arguing that the road to evidence-based policy is a ‘winding road’, highlighting the key turning points that influenced the institutionalisation of the policy in the IPS.

scholarly journals A Perspective on the Role of Point-of-Care “Immuno-Triaging” to Optimize COVID-19 Vaccination Distribution in a Time of Scarcity

2021 ◽  
Vol 9 ◽  
Author(s):  
Yi Zhang ◽  
Angela Rogers ◽  
Kari Nadeau ◽  
Jun Gu ◽  
Samuel Yang
Keyword(s):  
Decision Making ◽  
Large Scale ◽  
Point Of Care ◽  
Successful Implementation ◽  
Evidence Based ◽  
Individual Level ◽  
Societal Benefit ◽  
Decision Making Framework ◽  
The Individual

Vaccine bears hope to bring COVID-19 pandemic under control. With limited supply, vaccines must be utilized efficiently to provide protection to those who need it most. Currently, no practical framework has been proposed to ensure fair vaccine allocation at individual level, which is a recognized problem. We propose here an evidence-based decision-making framework for COVID-19 vaccine appropriation that prioritizes vaccine doses to individuals based on their immunological status, or immuno-triaging. To ensure successful implementation of the proposed framework, point-of-care (POC) immunodiagnostic testing is needed to quickly ramp up the testing capability. Considerations for deploying POC immunodiagnostic testing at such a large scale are discussed. We hope that the proposed immunological decision-making framework for evidence-based COVID-19 vaccine appropriation provides an objective approach to ensure fair and efficient utilization of the scarce vaccine resource at the individual level that also maximizes the collective societal benefit.

scholarly journals LO78: Ready for launch? A survey of readiness factors among 2019 Competence By Design launch disciplines

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S35-S36
Author(s):  
W. Cheung ◽  
A. Hall ◽  
T. Dalseg ◽  
A. Oswald ◽  
L. Cook ◽  
...  
Keyword(s):  
Large Scale ◽  
Online Survey ◽  
Specific Capacity ◽  
Major Change ◽  
Readiness For Change ◽  
Successful Implementation ◽  
Curriculum Mapping ◽  
General Capacity ◽  
Successful Launch ◽  
The Right

Introduction: A critical component for successful implementation of any innovation is an organization's readiness for change. Competence by Design (CBD) is the Royal College's major change initiative to reform the training of medical specialists in Canada. The purpose of this study was to measure readiness to implement CBD among the 2019 launch disciplines. Methods: An online survey was distributed to program directors of the 2019 CBD launch disciplines one month prior to implementation. Questions were developed based on the R = MC2 framework for organizational readiness. They addressed program motivation to implement CBD, general capacity for change, and innovation-specific capacity. Questions related to motivation and general capacity were scored using a 5-point scale of agreement. Innovation-specific capacity was measured by asking participants whether they had completed 33 key pre-implementation tasks (yes/no) in preparation for CBD. Bivariate correlations were conducted to examine the relationship between motivation, general capacity and innovation specific capacity. Results: Survey response rate was 42% (n = 79). A positive correlation was found between all three domains of readiness (motivation and general capacity, r = 0.73, p < 0.01; motivation and innovation specific capacity, r = 0.52, p < 0.01; general capacity and innovation specific capacity, r = 0.47, p < 0.01). Most respondents agreed that successful launch of CBD was a priority (74%). Fewer felt that CBD was a move in the right direction (58%) and that implementation was a manageable change (53%). While most programs indicated that their leadership (94%) and faculty and residents (87%) were supportive of change, 42% did not have experience implementing large-scale innovation and 43% indicated concerns about adequate support staff. Programs had completed an average of 72% of pre-implementation tasks. No difference was found between disciplines (p = 0.11). Activities related to curriculum mapping, competence committees and programmatic assessment had been completed by >90% of programs, while <50% of programs had engaged off-service rotations. Conclusion: Measuring readiness for change aids in the identification of factors that promote or inhibit successful implementation. These results highlight several areas where programs struggle in preparation for CBD launch. Emergency medicine training programs can use this data to target additional implementation support and ongoing faculty development initiatives.

Some applications of electron beam microanalysis techniques in VLSI process evaluation

1983 ◽  
Vol 41 ◽  
pp. 160-161
Author(s):  
Simon Thomas
Keyword(s):  
Integrated Circuits ◽  
Process Evaluation ◽  
Large Scale ◽  
Technology Development ◽  
Analytical Techniques ◽  
Successful Implementation ◽  
Analysis Of Failures ◽  
Characterization Of Materials ◽  
Circuits Vlsi

Trends in the technology development of very large scale integrated circuits (VLSI) have been in the direction of higher density of components with smaller dimensions. The scaling down of device dimensions has been not only laterally but also in depth. Such efforts in miniaturization bring with them new developments in materials and processing. Successful implementation of these efforts is, to a large extent, dependent on the proper understanding of the material properties, process technologies and reliability issues, through adequate analytical studies. The analytical instrumentation technology has, fortunately, kept pace with the basic requirements of devices with lateral dimensions in the micron/ submicron range and depths of the order of nonometers. Often, newer analytical techniques have emerged or the more conventional techniques have been adapted to meet the more stringent requirements. As such, a variety of analytical techniques are available today to aid an analyst in the efforts of VLSI process evaluation. Generally such analytical efforts are divided into the characterization of materials, evaluation of processing steps and the analysis of failures.

Evidence-based eHealth interventions for caregivers of people with dementia (Myinlife and Partner in Balance): Evaluation of implementations in municipality contexts (Preprint)

2020 ◽  
Author(s):  
Hannah Liane Christie ◽  
Lizzy Mitzy Maria Boots ◽  
Huibert Johannes Tange ◽  
Frans Rochus Josef Verhey ◽  
Marjolein Elizabeth de Vugt
Keyword(s):  
Self Efficacy ◽  
Measurement Instrument ◽  
Implementation Process ◽  
Successful Implementation ◽  
Evidence Based ◽  
Multiple Sources ◽  
Target Groups ◽  
Face To Face ◽  
People With Dementia ◽  
Implementation Context

BACKGROUND Very few evidence-based eHealth interventions for caregivers of people with dementia are implemented into practice. Municipalities are one promising context to implement these interventions, due to their available policy and innovation incentives regarding (dementia) caregiving and prevention. In this study, two evidence-based eHealth interventions for caregivers of people with dementia (Partner in Balance and Myinlife) were implemented in eight municipalities in the Euregion Meuse-Rhine. OBJECTIVE This study’s objectives were to (1.) evaluate this implementation and (2.) investigate determinants of successful implementation. METHODS This study collected eHealth usage data, Partner in Balance coach evaluation questionnaires, and information on implementation determinants. This was done by conducting interviews with the municipality officials, based on the Measurement Instrument for Determinants of Implementation (MIDI). This data from multiple sources and perspectives was integrated and analysed to form a total picture of the municipality implementation process. RESULTS The municipality implementation of Partner in Balance and Myinlife showed varying levels of success. In the end, three municipalities planned to continue the implementation of Partner in Balance, while none planned to continue the implementation of Myinlife. The two Partner in Balance municipalities that did not consider the implementation to be successful, viewed the implementation as an external project. For Myinlife, it was clear that more face-to-face contact was needed to engage the implementing municipality and the target groups. Successful implementations were linked to implementer self-efficacy CONCLUSIONS The experiences of implementing these interventions suggested that this implementation context was feasible regarding the required budget and infrastructure. The need to foster sense of ownership and self-efficacy in implementers will be integrated into future implementation protocols, as part of standard implementation materials for municipalities and organisations implementing Myinlife and Partner in Balance.

Leadership as a Facilitator of Evidence Implementation by Nurse Managers: A Metasynthesis

2021 ◽  
pp. 019394592110049
Author(s):  
María Zoraida Clavijo-Chamorro ◽  
Gema Romero-Zarallo ◽  
Adela Gómez-Luque ◽  
Fidel López-Espuela ◽  
Sebastián Sanz-Martos ◽  
...  
Keyword(s):  
Nurse Managers ◽  
Organizational Structures ◽  
Shared Vision ◽  
Readiness For Change ◽  
Staff Nurses ◽  
Evidence Based ◽  
Related Factors ◽  
Evidence Based Practices ◽  
Practical Experiences ◽  
Leadership Influence

Evidence-based practice is often not implemented in nursing for reasons relating to leadership. This article aims to cast light on the factors that facilitate nursing evidence implementation perceived by nurse managers in their practical experiences of this implementation. It is a qualitative, narrative metasynthesis of primary studies on nurse managers’ leadership-related facilitation experiences, following the Joanna Briggs Institute meta-aggregative approach and the Promoting Action on Research Implementation in Health Services (PARiHS) model. Eleven primary studies were included and three general categories were identified as leadership-related factors facilitating evidence implementation: teamwork (communication between managers and staff nurses), organizational structures (strategic governance), and transformational leadership (influence on evidence application and readiness for change among leaders). Nurse managers act as facilitators of evidence-based practices by transforming contexts to motivate their staff and move toward a shared vision of change. Always providing support as managers and colleagues, sharing their experience in the clinic environment.

scholarly journals Implementation support for contingency management: preferences of opioid treatment program leaders and staff

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Kelli Scott ◽  
Shelly Jarman ◽  
Samantha Moul ◽  
Cara M. Murphy ◽  
Kimberly Yap ◽  
...  
Keyword(s):  
Performance Feedback ◽  
Contingency Management ◽  
Scale Up ◽  
Team Approach ◽  
Evidence Based ◽  
Implementation Support ◽  
Training Performance ◽  
Opioid Treatment ◽  
Treatment Providers ◽  
External Facilitation

Abstract Background Contingency management (CM), a behavioral intervention that provides incentives for achieving treatment goals, is an evidence-based adjunct to medication to treat opioid use disorder. Unfortunately, many front-line treatment providers do not utilize CM, likely due to contextual barriers that limit effective training and ongoing support for evidence-based practices. This study applied user-informed approaches to adapt a multi-level implementation strategy called the Science to Service Laboratory (SSL) to support CM implementation. Methods Leaders and treatment providers working in community-based opioid treatment programs (OTPs; N = 43) completed qualitative interviews inquiring about their preferences for training and support implementation strategies (didactic training, performance feedback, and external facilitation). Our team coded interviews using a reflexive team approach to identify common a priori and emergent themes. Results Leaders and providers expressed a preference for brief training that included case examples and research data, along with experiential learning strategies. They reported a desire for performance feedback from internal supervisors, patients, and clinical experts. Providers and leaders had mixed feelings about audio-recording sessions but were open to the use of rating sheets to evaluate CM performance. Finally, participants desired both on-call and regularly scheduled external facilitation to support their continued use of CM. Conclusions This study provides an exemplar of a user-informed approach to adapt the SSL implementation support strategies for CM scale-up in community OTPs. Study findings highlight the need for user-informed approaches to training, performance feedback, and facilitation to support sustained CM use in this setting.

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