Department of Psychiatry, Yale School of Medicine, 950 Campbell Avenue, NEPEC/182, West Haven, CT 06516, USA.
Implement Sci. 2012 Jul 3;7:59. doi: 10.1186/1748-5908-7-59.
Greenhalgh et al. used a considerable evidence-base to develop a comprehensive model of implementation of innovations in healthcare organizations [1]. However, these authors did not fully operationalize their model, making it difficult to test formally. The present paper represents a first step in operationalizing Greenhalgh et al.'s model by providing background, rationale, working definitions, and measurement of key constructs.
A systematic review of the literature was conducted for key words representing 53 separate sub-constructs from six of the model's broad constructs. Using an iterative process, we reviewed existing measures and utilized or adapted items. Where no one measure was deemed appropriate, we developed other items to measure the constructs through consensus.
The review and iterative process of team consensus identified three types of data that can been used to operationalize the constructs in the model: survey items, interview questions, and administrative data. Specific examples of each of these are reported.
Despite limitations, the mixed-methods approach to measurement using the survey, interview measure, and administrative data can facilitate research on implementation by providing investigators with a measurement tool that captures most of the constructs identified by the Greenhalgh model. These measures are currently being used to collect data concerning the implementation of two evidence-based psychotherapies disseminated nationally within Department of Veterans Affairs. Testing of psychometric properties and subsequent refinement should enhance the utility of the measures.
Greenhalgh 等人使用了大量证据基础来开发医疗保健组织中创新实施的综合模型[1]。然而，这些作者并没有完全将其模型具体化，使得正式测试变得困难。本文通过提供背景、基本原理、工作定义以及关键结构的测量，代表了将 Greenhalgh 等人的模型具体化的第一步。
我们对文献进行了系统回顾，使用了代表模型六个广泛结构中的 53 个独立子结构的关键词。我们使用迭代过程审查了现有措施，并利用或改编了项目。在没有一个措施被认为是合适的情况下，我们通过共识开发了其他衡量这些结构的项目。
审查和团队共识的迭代过程确定了三种可用于将模型中的结构具体化的数据类型：调查项目、访谈问题和管理数据。报告了每种数据类型的具体示例。
尽管存在局限性，但使用调查、访谈措施和管理数据的混合方法测量方法可以通过为研究人员提供一种能够捕捉 Greenhalgh 模型中确定的大部分结构的测量工具，从而促进实施研究。这些措施目前正在用于收集全国范围内在退伍军人事务部传播的两种基于证据的心理治疗方法的实施数据。测试心理测量特性并进行后续改进应增强措施的实用性。
