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Hoorcolleges Implementatie Van Wetenschap naar Zorgpraktijk
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Het document bevat alle hoorcolleges waarin theorie behandeld werd, dus niet de werkcolleges.
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Hoorcolleges implementatieWeek 1 Introduction: Implementation Science 08-04-22
Redenen voor mislukte implementatie:
- Mensen staan er niet open voor
- Tijd voor verdiepen
- Interpretatie
- Geen prioriteit
- Middelen
Implementation – lessons learned from history
- James Lind – Scurvy in the British Royal Navy ‘case’
o 1497 Vasco da gama: 100 of 160 crew members died of Scurvy – lemon remedy
o 1747 experiment with lemon juice – solid evidence
o 1795 adopted by official admiralty order
o 1865 policy adopted by British Board of Trade
Slowest implementation ever 368 years
Gemiddeld duurt implementatie 17 jaar
Implementation – practice vs science
Implementation (practice)
- A planned process and systematic introduction of innovations and/or changes of proven
value; the aim being that these are give a structural place in professional practice, in het
functioning of organizations or in the health care structure
Implementation science
- The scientific study of methods to promote the systematic uptake of research findings and
other evidence-based practices into routine practice, and, hence, to improve the quality and
effectiveness of health services
Focus of implementation research
- The factors affecting the implementation
NOT the validation of evidence based programs
- Strategies to deliver or implement new interventions = implementation strategies
- Outcomes: implementation oucomes, (patient)effects
- Process of implementation (understanding outcomes)
Implementation models
- Bridging Research and Practice: models for dissemination and implementation research
Procesmodel: the implementation of change model (Wensing et al.)
1
, Categories of implementation strategies
- Continuering professional education
- Data-based feedback to clinicians
- Computerized decision support systems
- Patient empowerment
- Organizational changes
- Financial incentives
- Laws and regulations
Week 3 uitkomsten van implementatie 29-04-22
Stap 2 grol & Wensing: analysis of actual performance, targets for change (ook stap 6, 7)
Evaluation frameworks: RE-AIM, PRECEDE-PROCEED, Framework by Proctor et al.
Meten in implementatie onderzoek
- Doel stellen voor verbetering
- Bepalen (klinische) effectiviteit in nieuwe context/locatie
- Beoordeling effecten van implementatie strategie
- Begrijpen van succes/ falen
- Onderscheid maken tussen niet-effectieve strategie en niet-optimaal uitgevoerde strategie
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Indicatoren
- Structuur: focus op organisatie aspecten (beschikbaarheid poli, wastafels)
- Proces: focus op geleverde zorg (vaccinatiegraad, diagnose management)
- Uitkomst: focus op uiteindelijke doel van zorg (infecties verlagen)
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