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Surgeon views regarding the adoption of a novel surgical innovation into clinical practice: systematic review
Nagarjun N Konda1,2, Thomas L Lewis3, Hugh N Furness4
1Warwick Clinical Trials Unit, Warwick Medical School, The University of Warwick, Coventry, UK.
Background:
The haphazard adoption of new surgical technologies into practice has the potential to cause patient harm and there are many misconceptions in the decision-making behind the adoption of new innovations. The aim of this study was to synthesize factors affecting a surgeon's decision to adopt a novel surgical innovation into clinical practice.
Methods:
A systematic literature search was performed to obtain all studies where surgeon views on the adoption of a novel surgical innovation into clinical practice have been collected. The databases screened were MEDLINE, Embase, Science Direct, Scopus, the Web of Science, and the Cochrane Library of Systematic Reviews (last accessed October 2022). Innovations covered multiple specialties, including cardiac, general, urology, and orthopaedics. The quality of the papers was assessed using a 10-question Critical Appraisal Skills Programme (CASP) tool for qualitative research.
Results:
A total of 26 studies (including 1112 participants, of which 694 were surgeons) from nine countries satisfied the inclusion and exclusion criteria. Types of study included semi-structured interviews and focus groups, for example. Themes and sub-themes that emerged after a thematic synthesis were categorized using five causal factors (structural, organizational, patient-level, provider-level, and innovation-based). These themes were further split into facilitators and barriers. Key facilitators to adoption of an innovation include improved clinical outcomes, cost-effectiveness, and support from internal and external stakeholders. Barriers to adoption include lack of organizational support and views of senior surgeons.
Conclusion:
There are multiple complex factors that dynamically interact, affecting the adoption of a novel surgical innovation into clinical practice. There is a need to further investigate surgeon and other stakeholder views regarding the strength of clinical evidence required to support the widespread adoption of a surgical innovation into clinical practice.
Insights
Surgeons adopt new surgical innovations based on factors like clinical outcomes and cost. Barriers include lack of support and senior surgeon opinions, highlighting the need for evidence-based decision-making in surgical technology adoption.
Area of Science:
- Surgical innovation adoption
- Health technology assessment
- Medical practice management
Background:
- Haphazard adoption of new surgical technologies can lead to patient harm.
- Misconceptions influence decisions regarding the adoption of novel surgical innovations.
- Understanding surgeon decision-making is crucial for safe and effective technology integration.
Purpose of the Study:
- To synthesize factors influencing a surgeon's decision to adopt a novel surgical innovation into clinical practice.
- To identify facilitators and barriers to the adoption of new surgical technologies.
Main Methods:
- Systematic literature search across multiple databases (MEDLINE, Embase, etc.) up to October 2022.
- Included studies with surgeon views on novel surgical innovation adoption across various specialties.
- Assessed study quality using the Critical Appraisal Skills Programme (CASP) tool for qualitative research.
Main Results:
- 26 studies with 1112 participants (694 surgeons) from nine countries were analyzed.
- Thematic synthesis identified five causal factors: structural, organizational, patient-level, provider-level, and innovation-based.
- Key facilitators: improved clinical outcomes, cost-effectiveness, stakeholder support. Key barriers: lack of organizational support, senior surgeon views.
Conclusions:
- Multiple complex, interacting factors influence the adoption of novel surgical innovations.
- Further investigation is needed on surgeon and stakeholder views regarding evidence strength for widespread adoption.
- A structured approach to evaluating surgical innovations is essential to mitigate risks and optimize patient care.
