Smith James, Rapport Frances, O'Brien Tracey A, Smith Stephanie, Tyrrell Vanessa J, Mould Emily V A, Long Janet C, Gul Hossai, Cullis Jeremy, Braithwaite Jeffrey
Centre for Healthcare Resilience and Implementation Science, Australian Institute for Health Innovation, Macquarie University, Level 6, 75 Talavera Road, North Ryde, NSW, 2109, Australia.
Faculty of Medicine, School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia.
BMC Health Serv Res. 2020 May 21;20(1):449. doi: 10.1186/s12913-020-05289-0.
The concept of rapid implementation has emerged in the literature recently, but without a precise definition. Further exploration is required to distinguish the concept's unique meanings and significance from the perspective of implementation science. The study clarifies the concept of rapid implementation and identifies its attributes, antecedents, and consequences. We present a theoretical definition of rapid implementation to clarify its unique meaning and characteristics.
Rodgers evolutionary concept analysis method, combined with a systematic integrative review, were used to clarify the concept of rapid implementation. A comprehensive search of four databases, including EMBASE, MEDLINE, SCOPUS, and WEB OF SCIENCE was conducted, as well as relevant journals and reference lists of retrieved studies. After searching databases, 2442 papers were identified from 1963 to 2019; 24 articles were found to fit the inclusion criteria to capture data on rapid implementation from across healthcare settings in four countries. Data analysis was carried out using descriptive thematic analysis.
The results locate the introduction of rapid implementation, informed by implementation science. Guidance for further conceptualisation to bridge the gap between research and practice and redefine rigour, adapting methods used (current approaches, procedures and frameworks), and challenging clinical trial design (efficacy-effectiveness-implementation pipeline) is provided.
It is possible that we are on the cusp of a paradigm shift within implementation brought about by the need for faster results into practice and policy. Researchers can benefit from a deeper understanding of the rapid implementation concept to guide future implementation of rapid actionable results in clinical practice.
快速实施的概念最近在文献中出现，但尚无精确的定义。需要进一步探索，以便从实施科学的角度区分该概念的独特含义和意义。本研究阐明了快速实施的概念，并确定了其属性、前因和后果。我们提出了快速实施的理论定义，以阐明其独特的含义和特征。
采用罗杰斯进化概念分析法，并结合系统综合评价，以阐明快速实施的概念。对四个数据库进行了全面检索，包括EMBASE、MEDLINE、SCOPUS和科学网，以及相关期刊和检索研究的参考文献列表。在检索数据库后，从1963年至2019年共识别出2442篇论文；发现24篇文章符合纳入标准，以获取四个国家不同医疗环境中快速实施的数据。使用描述性主题分析法进行数据分析。
结果确定了快速实施的引入，并以实施科学为依据。提供了进一步概念化的指导，以弥合研究与实践之间的差距，重新定义严谨性，调整所使用的方法（当前的方法、程序和框架），并挑战临床试验设计（疗效-效果-实施流程）。
由于需要更快地将结果应用于实践和政策，我们可能正处于实施领域范式转变的边缘。研究人员可以从对快速实施概念的更深入理解中受益，以指导未来在临床实践中快速获得可操作结果的实施。
