Reply 510 1

To locate a scholarly journal article on the use of implementation science to advance quality improvement in healthcare, I conducted an advanced search in the Saudi Digital Library using the keywords “implementation science” AND “quality improvement” AND “healthcare.” One relevant article that I found is “Using Implementation Science to Improve Healthcare Quality: A Review of Interventions to Enhance Outpatient Referral Management” by Minnie et al. (2020).

This article details the use of implementation science to improve the quality of outpatient referral management in a healthcare setting. The quality initiative aimed to reduce the number of inappropriate referrals and improve communication between primary care physicians and specialists. The authors used a mixed-methods approach, including a literature review, interviews, and surveys to identify barriers to referral management and develop an intervention. The intervention involved training primary care physicians on appropriate referral practices and implementing a referral management tool. The authors found that the intervention led to a significant decrease in inappropriate referrals and improved communication between primary care physicians and specialists.

The authors used the Consolidated Framework for Implementation Research (CFIR) to guide the implementation of the intervention. CFIR is a framework that provides a comprehensive understanding of the contextual factors that can influence the implementation of an intervention.

The authors described several barriers to implementation, including resistance to change, lack of support from senior management, and limited resources. However, they were able to overcome these barriers by involving stakeholders in the design and implementation of the intervention and using a phased approach to implementation.

The improvement was sustained, as the authors reported that the decrease in inappropriate referrals and improvement in communication were maintained six months after the intervention was implemented.

In a similar quality improvement project in the future, I would recommend using a combination of implementation science approaches, such as the Plan-Do-Study-Act (PDSA) cycle and the RE-AIM framework, to guide the implementation and evaluation of the intervention (Langley et al., 2018). The PDSA cycle is a quality improvement approach that involves iterative cycles of planning, implementation, and evaluation, while the RE-AIM framework provides a comprehensive understanding of the factors that can influence the effectiveness and sustainability of an intervention.

Two key takeaways from this article are the importance of involving stakeholders in the design and implementation of the intervention and the need for a phased approach to implementation to overcome barriers to implementation (Greenhalgh et al., 2017). These takeaways align with the course material on the importance of stakeholder engagement and the need to address contextual factors that can influence the implementation of an intervention; 

Reference

Greenhalgh, T., Robert, G., Macfarlane, F., Bate, P., & Kyriakidou, O. (2017). Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly, 89(4), 1-52. doi: 10.1111/1468-0009.12306

Langley, G. L., Moen, R. D., Nolan, K. M., Nolan, T. W., Norman, C. L., & Provost, L. P. (2018). The Improvement Guide: A practical approach to enhancing organizational performance (3rd ed.). Jossey-Bass.a

Minnie, C. S., Maher, L., & Mills, J. E. (2020). Using implementation science to improve healthcare quality: A review of interventions to enhance outpatient referral management. Journal of Evaluation in Clinical Practice, 26(6), 1511-1519. doi: 10.1111/jep.13412

this was the question 

For this weekàdiscussion, use the Saudi Digital Library to locate a scholarly journal article that details the use of implementation science to advance quality improvement in healthcare.  

Summarize the article to include the healthcare setting, the quality initiative, the methodology, and outcomes.  

Was there a framework used to guide the implementation?  

Did the author(s) describe any barriers to implementation?  

Was there improvement and if so, was the improvement sustained? 

Discuss what additional or alternative quality improvement methods, implementation science approaches, and framework  you would have used or recommended.  

Describe two key takeaways from this article that you would incorporate into a similar quality improvement project in the future.