scholarly journals Identifying relevant concepts and factors for the sustainability of evidence-based practices within acute care contexts: a systematic review and theory analysis of selected sustainability frameworks

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Letitia Nadalin Penno ◽  
Barbara Davies ◽  
Ian D. Graham ◽  
Chantal Backman ◽  
Ibo MacDonald ◽  
...  
Keyword(s):  
Systematic Review ◽  
Acute Care ◽  
Future Research ◽  
Evidence Based ◽  
Theory Analysis ◽  
Evidence Based Practices ◽  
Team Members ◽  
Healthcare Settings ◽  
Sustained Use ◽  
Definition Of

Abstract Background There is growing recognition among healthcare professionals that the sustainability of evidence-based practices (EBPs) within different settings is variable and suboptimal. Understanding why a particular EBP might be sustained in one setting and not another remains unclear. Recent reviews illustrate the need to identify and analyze existing frameworks/models/theories (F/M/Ts) that focus solely on the sustainability of EBPs in specific healthcare settings, such as acute care, to illuminate key determinants and facilitate appropriate selection to guide practice and research. Methods We conducted a systematic review to extract sustainability frameworks. This involved using two available syntheses of the literature and a systematic search of four databases from January 2015 to July 2018: CINHAL, MEDLINE, Embase, and ProQuest. We included studies published in English, and if they included sustainability F/M/Ts recommended for use in acute care or an unspecified healthcare organization/setting. F/M/Ts explicitly recommended for use in public health and or community settings were excluded. We then conducted a comparative analysis of F/M/Ts using a modified theory analysis approach, to understand the theoretical underpinnings of each F/M/T, their determinants and concepts hypothesized to influence the sustained use of EBPs within an acute care context. Results Of 2967 identified citations from the 2 available syntheses and the systematic review, 8 F/M/Ts met the inclusion criteria. We identified 37 core factors, of which 16 were recorded as common factors (occurring within 4 or more of the 8 included F/M/Ts). All factors grouped into 7 main themes: innovation, adopters, leadership and management, inner context, inner processes, outer context, and outcomes. Conclusions This systematic review is the first to include a comprehensive analysis of healthcare sustainability F/M/Ts for the sustained use of EBPs in acute care settings. Findings reveal insights into sustainability as a “process or ongoing stage of use” following initial implementation, suggesting this construct should be added to the definition of sustainability. Results provide a resource of available F/M/Ts and hypothesized factors to consider for acute care team members who are planning or currently implementing EBPs with the goal of improving patient outcomes. It also provides a basis for future research on sustainability in acute care.

Resource Leveraging to Achieve Large-Scale Implementation of Effective Educational Practices

2018 ◽  
Vol 21 (2) ◽  
pp. 67-76 ◽  
Author(s):  
Robert H. Horner ◽  
Caryn S. Ward ◽  
Dean L. Fixsen ◽  
George Sugai ◽  
Kent McIntosh ◽  
...  
Keyword(s):  
Large Scale ◽  
Central Element ◽  
Scaling Up ◽  
Effective Practices ◽  
Future Research ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Measurement Planning ◽  
Definition Of ◽  
Resource Leveraging

We propose in this article that a central element in the large-scale implementation of evidence-based practices is the process by which initial investment in local demonstrations is leveraged into larger implementation efforts. We offer a definition of this “resource leveraging” and propose a process for both measuring and reporting the effects of leveraging. We suggest that resource leveraging become a valid focus of future research and that the intentional measurement, planning, and management of resource leveraging be used to improve the scaling-up of effective practices.

scholarly journals Virtual external implementation facilitation: successful methods for remotely engaging groups in quality improvement

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Christine W. Hartmann ◽  
Ryann L. Engle ◽  
Camilla B. Pimentel ◽  
Whitney L. Mills ◽  
Valerie A. Clark ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Improvement ◽  
Evidence Based ◽  
National Program ◽  
Extensive Experience ◽  
Evidence Based Practices ◽  
Team Members ◽  
Virtual Experience ◽  
Key Points ◽  
Program Content

Abstract Background Relatively little guidance exists on how to use virtual implementation facilitation to successfully implement evidence-based practices and innovations into clinical programs. Yet virtual methods are increasingly common. They have potentially wider reach, emergent public health situations necessitate their use, and restrictions on resources can make them more attractive. We therefore outline a set of principles for virtual external implementation facilitation and a series of recommendations based on extensive experience successfully using virtual external implementation facilitation in a national program. Model and recommendations Success in virtual external implementation facilitation may be achieved by facilitators applying three overarching principles: pilot everything, incorporate a model, and prioritize metacognition. Five practical principles also help: plan in advance, communicate in real time, build relationships, engage participants, and construct a virtual room for participants. We present eight concrete suggestions for enacting the practical principles: (1) assign key facilitation roles to facilitation team members to ensure the program runs smoothly; (2) create small cohorts of participants so they can have meaningful interactions; (3) provide clarity and structure for all participant interactions; (4) structure program content to ensure key points are described, reinforced, and practiced; (5) use visuals to supplement audio content; (6) build activities into the agenda that enable participants to immediately apply knowledge at their own sites, separate from the virtual experience; (7) create backup plans whenever possible; and (8) engage all participants in the program. Summary These principles represent a novel conceptualization of virtual external implementation facilitation, giving structure to a process that has been, to date, inadequately described. The associated actions are demonstrably useful in supporting the principles and offer teams interested in virtual external implementation facilitation concrete methods by which to ensure success. Our examples stem from experiences in healthcare. But the principles can, in theory, be applied to virtual external implementation facilitation regardless of setting, as they and the associated actions are not setting specific.

scholarly journals Team functioning and implementation of innovations in healthcare and human service settings: a systematic review protocol

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Elizabeth A. McGuier ◽  
David J. Kolko ◽  
Mary Lou Klem ◽  
Jamie Feldman ◽  
Grace Kinkler ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Human Service ◽  
Meta Analysis ◽  
Bibliographic Databases ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Implementation Outcomes ◽  
Services Implementation ◽  
Team Functioning

Abstract Background Healthcare and human services increasingly rely on teams of individuals to deliver services. Implementation of evidence-based practices and other innovations in these settings requires teams to work together to change processes and behaviors. Accordingly, team functioning may be a key determinant of implementation outcomes. This systematic review will identify and summarize empirical research examining associations between team functioning and implementation outcomes in healthcare and human service settings. Methods We will conduct a comprehensive search of bibliographic databases (e.g., MEDLINE, PsycINFO, CINAHL, ERIC) for articles published from January 2000 or later. We will include peer-reviewed empirical articles and conference abstracts using quantitative, qualitative, or mixed methods. We will include experimental or observational studies that report on the implementation of an innovation in a healthcare or human service setting and examine associations between team functioning and implementation outcomes. Implementation outcomes of interest are acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, and sustainability. Two reviewers will independently screen all titles/abstracts, review full-text articles, and extract data from included articles. We will use the Mixed Methods Appraisal Tool to assess methodological quality/bias and conduct a narrative synthesis without meta-analysis. Discussion Understanding how team functioning influences implementation outcomes will contribute to our understanding of team-level barriers and facilitators of change. The results of this systematic review will inform efforts to implement evidence-based practices in team-based service settings. Systematic review registration PROSPERO CRD42020220168

Examining Teaming and Tier 2 and 3 Practices Within a PBIS Framework

2021 ◽  
pp. 109830072110510
Author(s):  
Rhonda N. T. Nese ◽  
Angus Kittelman ◽  
M. Kathleen Strickland-Cohen ◽  
Kent McIntosh
Keyword(s):  
Behavioral Interventions ◽  
Data Use ◽  
Future Research ◽  
Evidence Based ◽  
Tier 2 ◽  
Behavior Support ◽  
Evidence Based Practices ◽  
Research And Practice ◽  
Positive Behavioral Interventions ◽  
Core Feature

One core feature of Positive Behavioral Interventions and Support (PBIS) is a systems-level teaming process for coordinating staff implementation of evidence-based practices and monitoring student progress across all three tiers. Prior research has shown schools that report regular teaming and team-based data use are more likely to successfully adopt and sustain implementation of multi-tiered systems of behavior support. However, more research is currently needed to better understand the various teaming configurations, structures, and practices commonly used by PBIS teams in typical schools, particularly at advanced tiers. For the current study, members of school and district PBIS teams representing 718 schools were surveyed to better understand (a) teaming configurations and practices currently being used in schools implementing PBIS and (b) common interventions that PBIS teams report implementing at Tiers 2 and 3. Survey findings are discussed, along with implications of those results for future research and practice in applied settings.

A Systematic Review of Meta-Analyses in Special Education: Exploring the Evidence Base for High-Leverage Practices

2021 ◽  
pp. 074193252110634
Author(s):  
Gena Nelson ◽  
Sara Cothren Cook ◽  
Kary Zarate ◽  
Sarah R. Powell ◽  
Daniel M. Maggin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Special Education ◽  
Students With Disabilities ◽  
Special Education Teachers ◽  
Evidence Base ◽  
Future Research ◽  
Evidence Based Practices ◽  
Intensive Instruction ◽  
Disability Categories ◽  
Meta Analyses

It is crucial that special education teachers are equipped with the knowledge and skills necessary to improve outcomes for students with disabilities. Despite federal legislation and efforts of the field to identify and disseminate evidence-based practices for students with disabilities, it is uncertain whether all special education teachers provide instruction based on the best available research. To better prepare special education teachers, McLeskey et al. proposed 22 high-leverage practices (HLPs). We conducted this systematic review of meta-analyses to provide an initial investigation of the experimental evidence reporting on the effectiveness of the HLPs for students with, or at risk for, a disability. Results indicated the largest amount of evidence from meta-analyses related to intensive instruction, explicit instruction, and social skills, with few meta-analyses reporting on collaboration and assessment. The results highlighted disproportional evidence according to disability categories. Implications for future research, practice, and teacher education are discussed.

scholarly journals Predictors of discharge destination from acute care in patients with traumatic brain injury

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016694 ◽  
Author(s):  
Sareh Zarshenas ◽  
Laetitia Tam ◽  
Angela Colantonio ◽  
Seyed Mohammad Alavinia ◽  
Nora Cullen
Keyword(s):  
Systematic Review ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Acute Care ◽  
English Language ◽  
Healthcare Providers ◽  
Trial Registration ◽  
Future Research ◽  
Reference List ◽  
Registration Number

IntroductionMany studies have assessed the predictors of morbidity/mortality of patients with traumatic brain injury (TBI) in acute care. However, with the increasing rate of survival after TBI, more attention has been given to discharge destinations from acute care as an important measure of clinical priorities. This study describes the design of a systematic review compiling and synthesising studies on the prognostic factors of discharge settings from acute care in patients with TBI.Methods and analysisThis systematic review will be conducted on peer-reviewed studies using seven databases including Medline/Medline in-Process, Embase, Cochrane Database of Systematic Reviews, Cochrane CENTRAL, PsycINFO, CINAHL and Supplemental PubMed. The reference list of selected articles and Google Scholar will also be reviewed to determine other relevant articles. This study will include all English language observational studies that focus on adult patients with TBI in acute care settings. The quality of articles will be assessed by the Quality in Prognostic Studies tool.Ethics and disseminationThe results of this review will provide evidence that may guide healthcare providers in making more informed and timely discharge decisions to the next level of care for patient with TBI. Also, this study will provide valuable information to address the gaps in knowledge for future research.Trial registration numberTrial registration number (PROSPERO) is CRD42016033046.

scholarly journals A Systematic Review of Evidence-Based Video Modeling for Students with Emotional and Behavioral Disorders

2018 ◽  
Vol 8 (4) ◽  
pp. 170 ◽  
Author(s):  
Soonhwa Seok ◽  
Boaventura DaCosta ◽  
Mikayla McHenry-Powell ◽  
Linda Heitzman-Powell ◽  
Katrina Ostmeyer
Keyword(s):  
Systematic Review ◽  
Quality Indicators ◽  
Behavioral Disorders ◽  
Video Modeling ◽  
Evidence Based Practice ◽  
Emotional And Behavioral Disorders ◽  
Future Research ◽  
Evidence Based ◽  
K 12 ◽  
Students With Ebd

This systematic review examined eight studies showing that video modeling (VM) can have a positive and significant effect for students with emotional and behavioral disorders (EBD). Building upon meta-analyses that sought evidence of video-based interventions decreasing problem behaviors of students with EBD in K-12 education, the review examined the standards of the Council for Exceptional Children (CEC) for evidence-based practice as well as additional quality indicators, neglected quality indicators, strategies combined with VM, the impact of the independent variables on the dependent variables, and common recommendations offered for future research. Findings revealed that the eight studies met the CEC standards for evidence-based practices as well as other quality indicators. For instance, all studies reported content and setting, participants, intervention agents, description of practice, as well as interobserver agreement and experimental control. According to the findings, fidelity index and effect size were the two most neglected quality indicators. Furthermore, instructions, reinforcement system, and feedback or discussion were the most common strategies used. Finally, generalizability—across settings, populations, treatment agents, target behaviors in the real world, and subject matter—was the most common recommendation for future research. While further investigation is warranted, these findings suggest that VM is an effective evidence-based practice for students with EBD when the CEC standards are met.

scholarly journals Advancing understanding and identifying strategies for sustaining evidence-based practices: a review of reviews

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Sarah A. Birken ◽  
Emily R. Haines ◽  
Soohyun Hwang ◽  
David A. Chambers ◽  
Alicia C. Bunger ◽  
...  
Keyword(s):  
Theory Model ◽  
Future Research ◽  
Evidence Based ◽  
Potential Contribution ◽  
Evidence Based Practices ◽  
The Past ◽  
Review Of Reviews ◽  
Conceptual Relationships ◽  
Continuous Use ◽  
Cast Analysis

Abstract Background Implementation science has focused mainly on the initial uptake and use of evidence-based practices (EBPs), with less attention to sustainment—i.e., continuous use of these practices, as intended, over time in ongoing operations, often involving adaptation to dynamic contexts. Declining EBP use following implementation is well-documented yet poorly understood. Using theories, models, and frameworks (TMFs) to conceptualize sustainment could advance understanding. We consolidated knowledge from published reviews of sustainment studies to identify TMFs with the potential to conceptualize sustainment, evaluate past uses of TMFs in sustainment studies, and assess the TMFs’ potential contribution to developing sustainment strategies. Methods We drew upon reviews of sustainment studies published within the past 10 years, evaluated the frequency with which included articles used a TMF for conceptualizing sustainment, and evaluated the relevance of TMFs to sustainment research using the Theory, Model, and Framework Comparison and Selection Tool (T-CaST). Specifically, we examined whether the TMFs were familiar to researchers, hypothesized relationships among constructs, provided a face-valid explanation of relationships, and included sustainment as an outcome. Findings Nine sustainment reviews referenced 648 studies; these studies cited 76 unique TMFs. Only 28 TMFs were used in more than one study. Of the 19 TMFs that met the criteria for T-CaST analysis, six TMFs explicitly included sustainment as the outcome of interest, 12 offered face-valid explanations of proposed conceptual relationships, and six identified mechanisms underlying relationships between included constructs and sustainment. Only 11 TMFs performed adequately with respect to all these criteria. Conclusions We identified 76 TMFs that have been used in sustainment studies. Of these, most were only used once, contributing to a fractured understanding of sustainment. Improved reporting and use of TMFs may improve understanding of this critical topic. Of the more consistently used TMFs, few proposed face-valid relationships between included constructs and sustainment, limiting their ability to advance our understanding and identify potential sustainment strategies. Future research is needed to explore the TMFs that we identified as potentially relevant, as well as TMFs not identified in our study that nonetheless have the potential to advance our understanding of sustainment and identification of strategies for sustaining EBP use.

Reducing Low-Value Practices a Functional-Contextual Consideration to Aid in De-Implementation Efforts

2020 ◽  
pp. 082957352097491
Author(s):  
Ryan L. Farmer ◽  
Imad Zaheer ◽  
Gary J. Duhon ◽  
Stephanie Ghazal
Keyword(s):  
Behavior Analysis ◽  
School Psychologists ◽  
Applied Behavior Analysis ◽  
Learning Theory ◽  
Implementation Strategies ◽  
Future Research ◽  
Operant Learning ◽  
Evidence Based ◽  
Evidence Based Practices

Through innovation in research and self-correction, it is inevitable that some practices will be replaced or be discredited for one reason or another. De-implementation of discredited and low-value practices is a necessary step for school psychologists’ maintenance of evidence-based practices and to reduce unnecessary costs and risk. However, efforts to clarify de-implementation frameworks and strategies are ongoing. The scope of this paper follows McKay et al. in considering the potential for de-implementation strategies to be informed by applied behavior analysis and operant learning theory. We conceptualize low-value practice as sets of behaviors evoked by their context and maintained by their consequences, and thus de-implementation as behavior reduction. We discuss the need for future research given this perspective.

Sign in / Sign up

Export Citation Format

Share Document