Ovretveit John, Mittman Brian, Rubenstein Lisa, Ganz David A
Karolinska Institutet, Stockholm, Sweden.
Department of Research and Evaluation, KPSC Research and Evaluation, Pasadena, California, USA.
Int J Health Care Qual Assur. 2017 Oct 9;30(8):755-768. doi: 10.1108/IJHCQA-01-2017-0019.
Purpose The purpose of this paper is to enable improvers to use recent knowledge from implementation science to carry out improvement changes more effectively. It also highlights the importance of converting research findings into practical tools and guidance for improvers so as to make research easier to apply in practice. Design/methodology/approach This study provides an illustration of how a quality improvement (QI) team project can make use of recent findings from implementation research so as to make their improvement changes more effective and sustainable. The guidance is based on a review and synthesis of improvement and implementation methods. Findings The paper illustrates how research can help a quality project team in the phases of problem definition and preparation, in design and planning, in implementation, and in sustaining and spreading a QI. Examples of the use of different ideas and methods are cited where they exist. Research limitations/implications The example is illustrative and there is little limited experimental evidence of whether using all the steps and tools in the one approach proposed do enable a quality team to be more effective. Evidence supporting individual guidance proposals is cited where it exists. Practical implications If the steps proposed and illustrated in the paper were followed, it is possible that quality projects could avoid waste by ensuring the conditions they need for success are in place, and sustain and spread improvement changes more effectively. Social implications More patients could benefit more quickly from more effective implementation of proven interventions. Originality/value The paper is the first to describe how improvement and implementation science can be combined in a tangible way that practical improvers can use in their projects. It shows how QI project teams can take advantage of recent advances in improvement and implementation science to make their work more effective and sustainable.
目的 本文旨在使改进者能够运用实施科学的最新知识，更有效地开展改进变革。它还强调了将研究成果转化为实用工具并为改进者提供指导的重要性，以便使研究更易于在实践中应用。
设计/方法/途径 本研究举例说明了质量改进（QI）团队项目如何利用实施研究的最新成果，使他们的改进变革更有效且可持续。该指导基于对改进和实施方法的回顾与综合。
研究结果 本文阐述了研究如何在问题定义与准备阶段、设计与规划阶段、实施阶段以及维持和推广质量改进方面帮助质量项目团队。文中列举了不同理念和方法的使用示例。
研究局限性/影响 该示例具有说明性，对于按照所提出的单一方法使用所有步骤和工具是否真能使质量团队更有效，几乎没有有限的实验证据。文中引用了支持个别指导建议的现有证据。
实际意义 如果遵循本文提出并说明的步骤，质量项目有可能通过确保成功所需的条件具备来避免浪费，并更有效地维持和推广改进变革。
社会影响 更多患者可以更快地从更有效地实施已证实的干预措施中受益。
原创性/价值 本文首次描述了如何以切实可行的方式将改进科学与实施科学结合起来，供实际的改进者在其项目中使用。它展示了质量改进项目团队如何利用改进科学和实施科学的最新进展，使他们的工作更有效且可持续。
