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Scaling Beyond Early Adopters: a Content Analysis of Literature and Key Informant Perspectives

BACKGROUND: Innovations and improvements in care delivery are often not spread across all settings that would benefit from their uptake. Scale-up and spread efforts are deliberate efforts to increase the impact of innovations successfully tested in pilot projects so as to benefit more people. The fi...

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Autores principales: Miake-Lye, Isomi, Mak, Selene, Lam, Christine A., Lambert-Kerzner, Anne C., Delevan, Deborah, Olmos-Ochoa, Tanya, Shekelle, Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7878615/
https://www.ncbi.nlm.nih.gov/pubmed/33111242
http://dx.doi.org/10.1007/s11606-020-06142-0
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author Miake-Lye, Isomi
Mak, Selene
Lam, Christine A.
Lambert-Kerzner, Anne C.
Delevan, Deborah
Olmos-Ochoa, Tanya
Shekelle, Paul
author_facet Miake-Lye, Isomi
Mak, Selene
Lam, Christine A.
Lambert-Kerzner, Anne C.
Delevan, Deborah
Olmos-Ochoa, Tanya
Shekelle, Paul
author_sort Miake-Lye, Isomi
collection PubMed
description BACKGROUND: Innovations and improvements in care delivery are often not spread across all settings that would benefit from their uptake. Scale-up and spread efforts are deliberate efforts to increase the impact of innovations successfully tested in pilot projects so as to benefit more people. The final stages of scale-up and spread initiatives must contend with reaching hard-to-engage sites. OBJECTIVE: To describe the process of scale-up and spread initiatives, with a focus on hard-to-engage sites and strategies to approach them. DESIGN: Qualitative content analysis of systematically identified literature and key informant interviews. PARTICIPANTS: Leads from large magnitude scale-up and spread projects. APPROACH: We conducted a systematic literature search on large magnitude scale-up and spread and interviews with eight project leads, who shared their perspectives on strategies to scale-up and spread clinical and administrative practices across healthcare systems, focusing on hard-to-engage sites. We synthesized these data using content analysis. KEY RESULTS: Searches identified 1919 titles, of which 52 articles were included. Thirty-four discussed general scale-up and spread strategies, 11 described hard-to-engage sites, and 7 discussed strategies for hard-to-engage sites. These included publications were combined with interview findings to describe a fourth phase of the national scale-up and spread process, common challenges for spreading to hard-to-engage sites, and potential benefits of working with hard-to-engage sites, as well as useful strategies for working with hard-to-engage sites. CONCLUSIONS: We identified scant published evidence that describes strategies for reaching hard-to-engage sites. The sparse data we identified aligned with key informant accounts. Future work could focus on better documentation of the later stages of spread efforts, including specific tailoring of approaches and strategies used with hard-to-engage sites. Spread efforts should include a “flexible, tailored approach” for this highly variable group, especially as implementation science is looking to expand its impact in routine care settings. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11606-020-06142-0) contains supplementary material, which is available to authorized users.
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spelling pubmed-78786152021-02-24 Scaling Beyond Early Adopters: a Content Analysis of Literature and Key Informant Perspectives Miake-Lye, Isomi Mak, Selene Lam, Christine A. Lambert-Kerzner, Anne C. Delevan, Deborah Olmos-Ochoa, Tanya Shekelle, Paul J Gen Intern Med Original Research BACKGROUND: Innovations and improvements in care delivery are often not spread across all settings that would benefit from their uptake. Scale-up and spread efforts are deliberate efforts to increase the impact of innovations successfully tested in pilot projects so as to benefit more people. The final stages of scale-up and spread initiatives must contend with reaching hard-to-engage sites. OBJECTIVE: To describe the process of scale-up and spread initiatives, with a focus on hard-to-engage sites and strategies to approach them. DESIGN: Qualitative content analysis of systematically identified literature and key informant interviews. PARTICIPANTS: Leads from large magnitude scale-up and spread projects. APPROACH: We conducted a systematic literature search on large magnitude scale-up and spread and interviews with eight project leads, who shared their perspectives on strategies to scale-up and spread clinical and administrative practices across healthcare systems, focusing on hard-to-engage sites. We synthesized these data using content analysis. KEY RESULTS: Searches identified 1919 titles, of which 52 articles were included. Thirty-four discussed general scale-up and spread strategies, 11 described hard-to-engage sites, and 7 discussed strategies for hard-to-engage sites. These included publications were combined with interview findings to describe a fourth phase of the national scale-up and spread process, common challenges for spreading to hard-to-engage sites, and potential benefits of working with hard-to-engage sites, as well as useful strategies for working with hard-to-engage sites. CONCLUSIONS: We identified scant published evidence that describes strategies for reaching hard-to-engage sites. The sparse data we identified aligned with key informant accounts. Future work could focus on better documentation of the later stages of spread efforts, including specific tailoring of approaches and strategies used with hard-to-engage sites. Spread efforts should include a “flexible, tailored approach” for this highly variable group, especially as implementation science is looking to expand its impact in routine care settings. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11606-020-06142-0) contains supplementary material, which is available to authorized users. Springer International Publishing 2020-10-27 2021-02 /pmc/articles/PMC7878615/ /pubmed/33111242 http://dx.doi.org/10.1007/s11606-020-06142-0 Text en © The Author(s) 2020 Open Access This 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/.
spellingShingle Original Research
Miake-Lye, Isomi
Mak, Selene
Lam, Christine A.
Lambert-Kerzner, Anne C.
Delevan, Deborah
Olmos-Ochoa, Tanya
Shekelle, Paul
Scaling Beyond Early Adopters: a Content Analysis of Literature and Key Informant Perspectives
title Scaling Beyond Early Adopters: a Content Analysis of Literature and Key Informant Perspectives
title_full Scaling Beyond Early Adopters: a Content Analysis of Literature and Key Informant Perspectives
title_fullStr Scaling Beyond Early Adopters: a Content Analysis of Literature and Key Informant Perspectives
title_full_unstemmed Scaling Beyond Early Adopters: a Content Analysis of Literature and Key Informant Perspectives
title_short Scaling Beyond Early Adopters: a Content Analysis of Literature and Key Informant Perspectives
title_sort scaling beyond early adopters: a content analysis of literature and key informant perspectives
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7878615/
https://www.ncbi.nlm.nih.gov/pubmed/33111242
http://dx.doi.org/10.1007/s11606-020-06142-0
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