Division of Cardiothoracic Surgery, Department of Surgery, Washington University Scho ol of Medicine, St Louis, Missouri.
Brown School of Public Health, Washington University in St Louis, St Louis, Missouri.
Ann Thorac Surg. 2022 Aug;114(2):373-382. doi: 10.1016/j.athoracsur.2021.08.007. Epub 2021 Sep 6.
Dissemination and implementation (D&I) science is the practice of taking evidence-based interventions and sustainably incorporating them into routine clinical practice. As a relatively young field, D&I techniques are underutilized in cardiothoracic surgery. This review offers an overview of D&I science from the context of the cardiothoracic surgeon. First, we provide a general introduction to D&I science and basic terminology that is used in the field. Second, to illustrate D&I techniques in a real-world example, we discuss a case study for implementing lung protective management strategies for lung donor optimization nationally. Finally, we discuss challenges to successful implementation that are unique to cardiothoracic surgery and give several examples of evidence-based interventions that have been poorly implemented into surgical practice. We also provide examples of successful D&I interventions-including deimplementation strategies-from other surgical subspecialties. We hope that this review offers additional tools for cardiothoracic surgeons to explore when introducing evidence-based interventions into routine practice.
传播和实施（D&I）科学是将基于证据的干预措施付诸实践并将其可持续地纳入常规临床实践的实践。作为一个相对较新的领域，D&I 技术在心胸外科中的应用尚未得到充分利用。这篇综述从心胸外科医生的角度概述了 D&I 科学。首先，我们提供了 D&I 科学的一般介绍和该领域中使用的基本术语。其次，为了在实际示例中说明 D&I 技术，我们讨论了一个全国范围内实施肺保护管理策略以优化肺供体的案例研究。最后，我们讨论了心胸外科特有的成功实施所面临的挑战，并提供了一些已在外科实践中实施不佳的基于证据的干预措施的示例。我们还提供了其他外科亚专业中成功的 D&I 干预措施（包括去实施策略）的示例。我们希望，当将基于证据的干预措施引入常规实践时，这篇综述为心胸外科医生提供了更多的工具。
