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Implementation science (IS) in surgical care focuses on evidence-based practices (EBPs). Key facilitators and barriers include leadership support, knowledge, teamwork, context, data, and resources for improving surgical quality.

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Area of Science:

  • Surgical Care
  • Implementation Science
  • Evidence-Based Practices

Background:

  • Surgical care improvement relies on evidence-based practices (EBPs), policies, and innovations.
  • Understanding the application of implementation science (IS) in surgery is crucial for advancing surgical practices.

Purpose of the Study:

  • To synthesize the existing literature on the use of implementation science (IS) in surgical care.
  • To identify the frequency and types of EBPs adopted in surgery.
  • To determine the IS frameworks, facilitators, and barriers influencing surgical innovations.

Main Methods:

  • A scoping review was conducted using a modified Arksey and O'Malley framework and PRISMA-ScR checklist.
  • Literature searches were performed across multiple databases (MEDLINE, PsycINFO, Embase, CINAHL, Web of Science, Google Scholar) from January 2001 to June 2023.
  • 129 manuscripts were included from an initial search of 3674 citations.

Main Results:

  • Innovations were most frequent in perioperative care, surgical safety, and Enhanced Recovery After Surgery (ERAS).
  • Six key constructs emerged as significant facilitators and barriers: leadership support, clinician knowledge of EBPs, teamwork, environmental context, data utilization, and resource availability.
  • The field of surgical IS is characterized by vast heterogeneity and a large volume of innovations.

Conclusions:

  • Identifying implementation factors aids in understanding adoption barriers and enablers for new surgical practices.
  • This knowledge supports practice change, enhances the quality and equity of surgical care.
  • The findings highlight research gaps for future implementation science studies in surgery.