Department of General Practice, School of Primary Health Care, Faculty of Medicine Nursing and Health Sciences, Monash University, Ferntree Gully Rd, Notting Hill, Victoria, Australia.
Implement Sci. 2013 Mar 15;8:32. doi: 10.1186/1748-5908-8-32.
To better understand the efficacy of various implementation strategies, improved methods for describing and classifying the nature of these strategies are urgently required. The aim of this study was to develop and pilot the feasibility of a taxonomy to classify the nature and content of implementation strategies.
A draft implementation taxonomy was developed based on the Cochrane Effective Practice and Organisation of Care (EPOC) data collection checklist. The draft taxonomy had four domains (professional, financial, organisational and regulatory) covering 49 distinct strategies. We piloted the draft taxonomy by using it to classify the implementation strategies described in the conference abstracts of the implementation stream of the 2010 Guideline International Network Conference. Five authors classified the strategies in each abstract individually. Final categorisation was then carried out in a face-to-face consensus meeting involving three authors.
The implementation strategies described in 71 conference abstracts were classified. Approximately 15.5% of abstracts utilised strategies that could not be categorised using the draft taxonomy. Of those strategies that could be categorised, the majority were professionally focused (57%). A total of 41% of projects used only one implementation strategy, with 29% using two and 31% three or more. The three most commonly used strategies were changes in quality assurance, quality improvement and/or performance measurement systems, changes in information and communication technology, and distribution of guideline materials (via hard-copy, audio-visual and/or electronic means).
Further refinement of the draft taxonomy is required to provide hierarchical dimensions and granularity, particularly in the areas of patient-focused interventions, those concerned with audit and feedback and quality improvement, and electronic forms of implementation, including electronic decision support.
为了更好地了解各种实施策略的效果，迫切需要改进描述和分类这些策略的性质的方法。本研究旨在开发和试点一种分类法，以分类实施策略的性质和内容，并检验其可行性。
基于 Cochrane 有效实践和组织保健（EPOC）数据收集清单，制定了实施分类法草案。该分类法草案有四个领域（专业、财务、组织和监管），涵盖了 49 种不同的策略。我们通过使用该分类法草案来对 2010 年指南国际网络会议实施部分会议摘要中描述的实施策略进行试点，以检验其可行性。五位作者单独对每个摘要中的策略进行分类。然后，在涉及三位作者的面对面共识会议上进行最终分类。
对 71 个会议摘要中描述的实施策略进行了分类。约有 15.5%的摘要中使用的策略无法使用分类法草案进行分类。在可分类的策略中，大多数是专业集中的（57%）。总共 41%的项目只使用了一种实施策略，29%使用了两种，31%使用了三种或更多。使用最多的三种策略是质量保证、质量改进和/或绩效测量系统的变化，信息和通信技术的变化，以及指南材料的分发（通过硬拷贝、视听和/或电子手段）。
需要进一步细化分类法草案，以提供层次维度和粒度，特别是在以患者为中心的干预措施、涉及审核和反馈以及质量改进以及电子形式的实施，包括电子决策支持方面。
