Implementation Outcome Repository

Implementation Outcome Repository 

• A free online resource for implementation stakeholders, including researchers and healthcare professionals, wishing to quantitatively measure implementation outcomes. 
• Developed by researchers in the Centre for Implementation Science at King’s College London, King's Improvement Science and the Behavioural and Implementation Science research group at the University of East Anglia.

How to specify healthcare process improvements collaboratively using rapid, remote consensus-building

How to specify healthcare process improvements collaboratively using rapid, remote consensus-building: a framework and a case study of its application. 

BMC Med Res Methodol 21, 103 (2021). https://doi.org/10.1186/s12874-021-01288-9

• Researchers have developed an approach for engaging diverse stakeholders remotely in a consensus-building exercise to help specify improvements in a healthcare process. Using Thiscovery (https://www.thiscovery.org/about), an online research and development platform created and developed by THIS Institute at the University of Cambridge, they tested the approach in a case study that sought to specify process improvements for the management of obstetric emergencies during the COVID-19 pandemic.
• Read the THIS Institute blog 

National Centre for Creative Health

National Centre for Creative Health

• The National Centre for Creative Health  (NCCH) will advance good practice and research, inform policy and promote collaboration, helping foster the conditions for creative health to be integral to health and social care and wider systems.
• It was formed in response to the Creative Health report, the result of a two-year inquiry led by the All-Party Parliamentary Group on Arts, Health and Wellbeing. 
• NCCH priorities are: health inequalities; advancing good practice and research; informing policy; and promoting collaboration. NCCH are working with to create place-based ‘Hubs’, develop partnership and collaboration ‘Hives’ and co-produce creative learning in ‘Huddles’. 
• Evaluation of activities will be based on the NCCH Theory of Change.

Improving flow along care pathways: Learning from the Flow Coaching Academy programme

Improving flow along care pathways: Learning from the Flow Coaching Academy programme
Health Foundation November 2020

• The Flow Coaching Academy (FCA) programme is based on a co-coaching model combined with elements of improvement science. It aims to support establishing multiple FCAs across the UK, to scale up the approach and to build a community of practice to share learning. The training focuses on both the technical and relationship skills required to deliver continuous and sustainable improvement.

The Beneficial Changes Network

The Beneficial Changes Network

• The Beneficial Changes Network has come together to build on the incredible ways in which people and systems have responded to COVID-19 through innovation and collaboration, whilst safeguarding effective health and care delivery. The Network is a collaborative group of health and social care stakeholders and people with lived experience who want to harness and capture the benefits, evaluate these changes, to share the knowledge and embed the learning across the entire health and care sector.
• See case studies and practical guidance on the FutureNHS platform [registration required]

How can we learn from changes in practice under COVID-19?

How can we learn from changes in practice under COVID-19? A guide for health and care teams to learn from innovations during the pandemic
Analytical Collaboration for COVID-19 October 2020

• This guide has been developed to help health and social care teams and their leaders learn from service changes put in place or accelerated during the COVID-19 response. Includes useful tools and resources eg learning frameworks, knowledge mobilisation, sharing learning, evaluation.
• Produced as part of the Analytical Collaboration for COVID-19 which brings together: the Health Foundation; King’s Fund; Nuffield Trust, Imperial College Health Partners and the Strategy Unit.

Skills for collaborative change: a map and user guide

Skills for collaborative change: a map and user guide
Q Health 29 September 2020

• A practical tool setting out the skills and attitudes needed for collaborative and creative problem-solving. he map and user guide is designed to support individuals and teams to have meaningful conversations about what it takes to do collaboration well and how to use those skills in practice.

A systematic scoping review of change management practices used for telemedicine service implementations.

A systematic scoping review of change management practices used for telemedicine service implementations.
BMC Health Serv Res 20, 815 (2020). https://doi.org/10.1186/s12913-020-05657-w  

• Areview of the evidence identified 16 change management practices relating to either strategic or operational aspects of telemedicine implementations. The authors suggest that the slow rate of adoption of telemedicine may be due to a piecemeal approach to the change process, and a lack of understanding of how to plan, manage and reinforce change when implementing telemedicine services.

The barriers and facilitators influencing the sustainability of hospital-based interventions

The barriers and facilitators influencing the sustainability of hospital-based interventions: a systematic review.
BMC Health Serv Res 20, 588 (2020). https://doi.org/10.1186/s12913-020-05434-9

• This study aimed to identify, appraise and synthesise the barriers and facilitators that influenced the delivery of sustained healthcare interventions in a hospital-based setting. A systematic review identified 32 interventions or programmes all of which were multicomponent with the majority aimed at improving the quality of patient care and/ or safety. Key facilitators included clear accountability of roles, strong leadership , support at organisational level. The most frequently reported barrier to sustainability was inadequate staff resourcing.

Better Evaluations to Support the Needs of Older People in the UK

Better Evaluations to Support the Needs of Older People in the UK
RAND Health Quarterly, 2020; 8(4):1

• This article by researchers at RAND Europe summarises three workshops undertaken with evaluators, commissioners of evaluations and services for older people, and those delivering services that are evaluated to reflect on ways to improve how evaluations are commissioned, completed and used in a changing policy landscape.
• It was broadly agreed that the areas to address were:
• Relevance: evaluations were too often not focused on major challenges and consequently findings were “unsurprising” or even trivial.
• Timeliness: evaluation findings were often not available when decisions had to be made.
• Replication and lack of cumulative building of knowledge: evaluations were often designed as stand-alone pieces rather than building on previous evaluations and contributing to future evaluations.
• Reluctance to share knowledge: competition, a lack of clarity in communication, and poor knowledge management/mobilisation led to a reluctance to share information, pool data, or drew on the evaluations of potential competitors.
• Efficiency: evaluations often failed to use routine data and ignored the costs imposed on service providers and users.

Best evidence, but does it really change practice?

Best evidence, but does it really change practice? [Editorial]
BMJ Quality & Safety 06 January 2020. doi: 10.1136/bmjqs-2019-010513

• An editorial considering an article which examines the impact of three widely known orthopaedic trauma RCTs and the subsequent Health Technology Assessment (HTA) reports and their uptake in clinical practice.
• "Contrary to trials with medications, surgical trials may include a new technique or a new prosthesis that requires a particular skill set. Conversely, surgeons have already spent considerable time acquiring and improving surgical skills for procedures they already perform, so they may find disinvestment hard to accept if, as in these three trials examined by Reeves and colleagues demonstrated, less-invasive treatment performed better."
• "To aid in the clinical uptake of evidence-based medicine, policy initiatives may need to go hand in hand with the publication of trials and subsequent recommendations. For some medical services or procedures, new evidence will not be implemented by itself but requires a managed process, referred to as deimplementation."

Implementation of change - GIRFT

Implementation of change - GIRFT
Leadership Matters, TVSCN Q3 2019

• Read about the impact of a a GIRFT & Clinical Variation Board at Buckinghamshire Healthcare NHS Trust which support adoption of the GIRFT programme. Data is collected in a dedicated GIRFT tracker to evidence the baseline position, improvements required and the associated financial benefit/costs.

AI in the NHS: Fad - or the future?

Artificial Intelligence in the NHS: Fad - or the future?
Royal Society for the encouragement of Arts, Manufactures and Commerce (RSA) 30 October 2019

• Report of a collaboration between the RSA and NHSX looking at the ways in which radical technologies, such as AI and automated decision systems are influencing commissioning and clinical practice in the health system. 
• The RSA undertook a series of interviews with actors across the NHS and the wider health system who are involved in the design, innovation, delivery, clinical management or implementation of AI. 
• Summary findings and recommendations to NHSX are: Patient adoption is key, Evidence is essential, Clinical champions are an important part of the AI proposition to help shift attitudes and practices so as to collectively build a culture of innovation.

Causal thinking for embedded, integrated implementation research

Causal thinking for embedded, integrated implementation research
Evidence & Policy January 2019 v15(1) pp. 125-141

• Research evidence indicates that the uptake of evidence-based practice is minimally realised. This paper proposed an embedded, integrated research agenda motivated with causal thinking for knowledge of when and how to adapt interventions and implementation to achieve effective practice.

Abstract

Understanding how and why the NHS adopts innovation

Understanding how and why the NHS adopts innovation
NHS Innovation Accelerator 6 November 2018

• Aiming to get to the heart of how innovation decisions are made within NHS organisations, this research considers: 
• How and why organisations take up an innovation 
• The enabling factors which facilitate the uptake and embedding of an innovation 
• The impacts of adopting an innovation on organisational practices.
• Based on case studies of nine of the NIA innovations, the analysis is organised into three sections: the adoption journey, the adoption network, and common tasks in the adoption journey.
• Two sets of ‘top ten tips’ have been developed for innovators and adopting organisations. 

The Spread Challenge

The Spread Challenge
Health Foundation September 2018

• Why the uptake of new ideas to improve care can be so difficult and how the NHS can be supported to do it better. 
• "Generating acceptance of the need for change and the motivation to change can require far more than the presentation of evidence." p42