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Related Experiment Videos

Developing and implementing new safe practices: voluntary adoption through statewide collaboratives.

L L Leape1, G Rogers, D Hanna

  • 1Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA. leape@hsph.harvard.edu

Quality & Safety in Health Care
|August 4, 2006
PubMed
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A statewide initiative developed a framework to implement new safe practices in hospitals. High participation was achieved, with significant progress in reconciling medications and communicating critical test results.

Area of Science:

  • Healthcare quality improvement
  • Patient safety practices
  • Implementation science

Background:

  • Disseminating new safe practices in healthcare settings presents significant challenges.
  • A statewide initiative was launched to address these challenges by developing a structured framework for practice implementation.
  • The framework focused on selecting practices, detailing implementation, recruiting hospitals, and facilitating adoption.

Purpose of the Study:

  • To develop and evaluate a framework for selecting and implementing new safe practices in hospitals.
  • To assess the feasibility and effectiveness of a collaborative model for disseminating healthcare innovations.
  • To identify factors influencing hospital participation and team success in implementing evidence-based practices.

Main Methods:

Related Experiment Videos

  • A multistep process identified candidate practices, followed by evidence review and selection based on importance, efficacy, feasibility, and impact.
  • Two practices were selected: reconciling medications (RM) and communicating critical test results (CTR).
  • A collaborative model, including expert guidance and toolkits, was used to facilitate implementation over 18 months.

Main Results:

  • A high hospital participation rate of 88% was achieved for one or both collaboratives.
  • Partial implementation of RM and CTR practices was achieved by 50% and 65% of teams, respectively.
  • Full implementation was achieved by 20% of teams for each practice.

Conclusions:

  • Hospital participation was driven by the appeal of practices, expert access, and available implementation strategies.
  • Team success correlated with senior administrator and physician engagement, use of PDSA cycles, and meeting attendance.
  • Thorough development of subpractices and implementation strategies prior to hospital engagement is crucial for successful guideline adoption.