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The barriers and facilitators influencing the sustainability of hospital-based interventions: a systematic review

BACKGROUND: Identifying factors that influence sustained implementation of hospital-based interventions is key to ensuring evidence-based best practice is maintained across the NHS. This study aimed to identify, appraise and synthesise the barriers and facilitators that influenced the delivery of su...

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Autores principales: Cowie, Julie, Nicoll, Avril, Dimova, Elena D., Campbell, Pauline, Duncan, Edward A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7321537/
https://www.ncbi.nlm.nih.gov/pubmed/32594912
http://dx.doi.org/10.1186/s12913-020-05434-9
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author Cowie, Julie
Nicoll, Avril
Dimova, Elena D.
Campbell, Pauline
Duncan, Edward A.
author_facet Cowie, Julie
Nicoll, Avril
Dimova, Elena D.
Campbell, Pauline
Duncan, Edward A.
author_sort Cowie, Julie
collection PubMed
description BACKGROUND: Identifying factors that influence sustained implementation of hospital-based interventions is key to ensuring evidence-based best practice is maintained across the NHS. 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. METHODS: A systematic review reported in accordance with PRISMA. Eight electronic databases were reviewed in addition to a hand search of Implementation Science journal and reference lists of included articles. Two reviewers were used to screen potential abstracts and full text papers against a selection criteria. Study quality was also independently assessed by two reviewers. Barriers and facilitators were extracted and mapped to a consolidated sustainability framework. RESULTS: Our searching identified 154,757 records. We screened 14,626 abstracts and retrieved 431 full text papers, of which 32 studies met the selection criteria. The majority of studies employed a qualitative design (23/32) and were conducted in the UK (8/32) and the USA (8/32). Interventions or programmes were all multicomponent, with the majority aimed at improving the quality of patient care and/ or safety (22/32). Sustainability was inconsistently reported across 30 studies. Barriers and facilitators were reported in all studies. The key facilitators included a clear accountability of roles and responsibilities (23/32); ensuring the availability of strong leadership and champions advocating the use of the intervention (22/32), and provision of adequate support available at an organisational level (21/32). The most frequently reported barrier to sustainability was inadequate staff resourcing (15/32). Our review also identified the importance of inwards spread and development of the initiative over time, as well as the unpredictability of sustainability and the need for multifaceted approaches. CONCLUSIONS: This review has important implications for practice and research as it increases understanding of the factors that faciliate and hinder intervention sustainability. It also highlights the need for more consistent and complete reporting of sustainability to ensure that lessons learned can be of direct benefit to future implementation of interventions. TRIAL REGISTRATION: The review is registered on PROSPERO (CRD42017081992).
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spelling pubmed-73215372020-06-29 The barriers and facilitators influencing the sustainability of hospital-based interventions: a systematic review Cowie, Julie Nicoll, Avril Dimova, Elena D. Campbell, Pauline Duncan, Edward A. BMC Health Serv Res Research Article BACKGROUND: Identifying factors that influence sustained implementation of hospital-based interventions is key to ensuring evidence-based best practice is maintained across the NHS. 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. METHODS: A systematic review reported in accordance with PRISMA. Eight electronic databases were reviewed in addition to a hand search of Implementation Science journal and reference lists of included articles. Two reviewers were used to screen potential abstracts and full text papers against a selection criteria. Study quality was also independently assessed by two reviewers. Barriers and facilitators were extracted and mapped to a consolidated sustainability framework. RESULTS: Our searching identified 154,757 records. We screened 14,626 abstracts and retrieved 431 full text papers, of which 32 studies met the selection criteria. The majority of studies employed a qualitative design (23/32) and were conducted in the UK (8/32) and the USA (8/32). Interventions or programmes were all multicomponent, with the majority aimed at improving the quality of patient care and/ or safety (22/32). Sustainability was inconsistently reported across 30 studies. Barriers and facilitators were reported in all studies. The key facilitators included a clear accountability of roles and responsibilities (23/32); ensuring the availability of strong leadership and champions advocating the use of the intervention (22/32), and provision of adequate support available at an organisational level (21/32). The most frequently reported barrier to sustainability was inadequate staff resourcing (15/32). Our review also identified the importance of inwards spread and development of the initiative over time, as well as the unpredictability of sustainability and the need for multifaceted approaches. CONCLUSIONS: This review has important implications for practice and research as it increases understanding of the factors that faciliate and hinder intervention sustainability. It also highlights the need for more consistent and complete reporting of sustainability to ensure that lessons learned can be of direct benefit to future implementation of interventions. TRIAL REGISTRATION: The review is registered on PROSPERO (CRD42017081992). BioMed Central 2020-06-28 /pmc/articles/PMC7321537/ /pubmed/32594912 http://dx.doi.org/10.1186/s12913-020-05434-9 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Cowie, Julie
Nicoll, Avril
Dimova, Elena D.
Campbell, Pauline
Duncan, Edward A.
The barriers and facilitators influencing the sustainability of hospital-based interventions: a systematic review
title The barriers and facilitators influencing the sustainability of hospital-based interventions: a systematic review
title_full The barriers and facilitators influencing the sustainability of hospital-based interventions: a systematic review
title_fullStr The barriers and facilitators influencing the sustainability of hospital-based interventions: a systematic review
title_full_unstemmed The barriers and facilitators influencing the sustainability of hospital-based interventions: a systematic review
title_short The barriers and facilitators influencing the sustainability of hospital-based interventions: a systematic review
title_sort barriers and facilitators influencing the sustainability of hospital-based interventions: a systematic review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7321537/
https://www.ncbi.nlm.nih.gov/pubmed/32594912
http://dx.doi.org/10.1186/s12913-020-05434-9
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