Kochevar Laura K, Yano Elizabeth M
VA Colorectal Cancer QUERI and Center for Chronic Disease Outcomes Research Minneapolis VAMC, Minneapolis, MN 55417, USA.
J Gen Intern Med. 2006 Feb;21 Suppl 2(Suppl 2):S25-9. doi: 10.1111/j.1525-1497.2006.00359.x.
Significant efforts have been invested in improving our understanding of how to accelerate and magnify the impact of research on clinical practice. While approaches to fostering translation of research into practice are numerous, none appears to be superior and the evidence for their effectiveness is mixed. Lessons learned from formative evaluation have given us a greater appreciation of the contribution of context to successful implementation of quality improvement interventions. While formative evaluation is a powerful tool for addressing context effects during implementation, lessons learned from the social sciences (including management and operations research, sociology, and public health) show us that there are also powerful preimplementation tools available to us. This paper discusses how we might integrate these tools into implementation research. We provide a theoretical framework for our need to understand organizational contexts and how organizational characteristics can alert us to situations where preimplementation tools will prove most valuable.
为了更好地理解如何加速和扩大研究对临床实践的影响，人们付出了巨大努力。虽然促进研究转化为实践的方法众多，但似乎没有一种方法是最优的，而且其有效性的证据也参差不齐。从形成性评价中吸取的经验教训，让我们更加认识到背景因素对成功实施质量改进干预措施的重要性。虽然形成性评价是在实施过程中应对背景效应的有力工具，但社会科学（包括管理与运筹学、社会学和公共卫生学）的经验教训表明，我们也有强大的实施前工具可用。本文讨论了如何将这些工具整合到实施研究中。我们提供了一个理论框架，以说明我们为何需要了解组织背景，以及组织特征如何提醒我们哪些情况下实施前工具将最具价值。
