Pascoe Kelley M, Petrescu-Prahova Miruna, Steinman Lesley, Bacci Jennifer, Mahorter Siobhan, Belza Basia, Weiner Bryan
School of Public Health, Department of Health Systems and Population Health, University of Washington, Seattle, USA.
School of Public Health, Health Promotion Research Center, University of Washington, Seattle, USA.
Implement Res Pract. 2021 Sep 13;2:26334895211034581. doi: 10.1177/26334895211034581. eCollection 2021 Jan-Dec.
Evidence-based programs (EBPs) are used across disciplines to integrate research into practice and improve outcomes at the individual and/or community level. Despite widespread development and implementation of EBPs, many programs are not sustained beyond the initial implementation period due to many factors, including workforce turnover. This scoping review summarizes research on the impact of workforce turnover on the sustainability of EBPs and recommendations for mitigating these impacts.
We searched 10 databases for articles that focused on an EBP and described an association between workforce turnover and the sustainment or sustainability of the program. We created a data abstraction tool to extract relevant information from each article and applied the data abstraction tool to all included articles to create the dataset. Data were mapped and analyzed using the program sustainability framework (PSF).
A total of 30 articles were included in this scoping review and mapped to the PSF. Twenty-nine articles described impacts of workforce turnover and 18 articles proposed recommendations to address the impacts. The most frequent impacts of workforce turnover included increased need for training, loss of organizational knowledge, lack of EBP fidelity, and financial stress. Recommendations to address the impact of workforce turnover included affordable and alternative training modalities, the use of champions or volunteers, increasing program alignment with organizational goals, and generating diverse funding portfolios.
The sustainment of EBPs is critical to ensure and maintain the short- and long-term benefits of the EBP for all participants and communities. Understanding the impacts of workforce turnover, a determinant of sustainability, can create awareness among EBP-implementing organizations and allow for proactive planning to increase the likelihood of program sustainability.
循证项目（EBPs）在各个学科中被用于将研究成果整合到实践中，并在个人和/或社区层面改善结果。尽管循证项目得到了广泛的发展和实施，但由于包括员工流动率在内的多种因素，许多项目在初始实施期之后无法持续下去。本范围综述总结了关于员工流动率对循证项目可持续性的影响的研究，以及减轻这些影响的建议。
我们在10个数据库中搜索了聚焦于循证项目并描述员工流动率与项目维持或可持续性之间关联的文章。我们创建了一个数据提取工具，从每篇文章中提取相关信息，并将该数据提取工具应用于所有纳入的文章以创建数据集。使用项目可持续性框架（PSF）对数据进行映射和分析。
本范围综述共纳入30篇文章，并映射到PSF。29篇文章描述了员工流动率的影响，18篇文章提出了应对这些影响的建议。员工流动率最常见的影响包括培训需求增加、组织知识流失、循证项目保真度不足以及财务压力。应对员工流动率影响的建议包括负担得起的替代培训方式、使用倡导者或志愿者、使项目与组织目标更加契合以及生成多样化的资金组合。
循证项目的可持续性对于确保和维持循证项目对所有参与者和社区的短期和长期益处至关重要。了解作为可持续性决定因素的员工流动率的影响，可以提高循证项目实施组织的认识，并允许进行积极规划以增加项目可持续性的可能性。
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