Reply:
According to Wensing (2015), the field of study known as “implementation science” focuses on how to best facilitate the transfer of medical research discoveries into everyday practice, whether in the hospital, the office, or the government. Even though they share a common goal, implementation science and improvement science use different approaches to achieving that goal. Although improvement science is concerned with continuously monitoring and bettering care processes and systems, implementation science is concerned with boosting the acceptance of evidence-based interventions (Koczwara et al., 2018).
The discipline of improvement practice, which is similarly concerned with bettering healthcare’s procedures and infrastructures, is where improvement science got its start. Different from improvement science, improvement practice seeks to generate the site-specific (rather than transferable) knowledge essential to enhancing patient care (Leeman et al., 2021).
Summarize the article to include the healthcare setting, the quality initiative, the methodology, and outcomes:
Setting: The Veterans Affairs Grinieater Los Angeles Healthcare System (VAGLAHS) is an integrated healthcare system for veterans in the metropolitan Los Angeles region. One acute care hospital with clinics, two community living facilities, two ambulatory care centers with primary care and some specialist services, and ten community-based outpatient clinics with largely primary care comprise the system.
Quality initiative: Implementation of a fall prevention program.
Methodology: Program development included key players in the effort. The theory-derived plan included 1) an initial leadership meeting to agree on whether creating a fall prevention program was a priority for the organization, 2) focus groups with patients and health care professionals to develop program ideas, 3) monthly workgroup meetings with representatives from key departments to develop a program blueprint, 4) a second leadership meeting to confirm that the workgroup’s blueprint was satisfactory (Ganz et al., 2019).
Outcomes: The scheduled leadership and workgroup sessions produced a workable program. The fall prevention program employs a nurse advice line to 1) phone high-risk patients, 2) analyze their fall risk factors, and 3) route them to the right resources. The workgroup monitors and improves the program monthly (Ganz et al., 2019).
Was there a framework used to guide the implementation?
They envisioned a program development approach that would harmonize stakeholder interests to create a prototype fall prevention program that could be deployed, sustained, and enhanced for VAGLAHS outpatient veterans. They planned program creation and execution using several theories and existing experience, following earlier research-to-practice efforts. Organizational theory, VA strategic priorities, diffusion of innovations theory, and continuous quality improvement concepts were used (Ganz et al., 2019).
Did the author(s) describe any barriers to implementation? :
Although this article focused on how some participants were resistant to the improvement program’s implementation due to the pressure from above, ultimately, each individual’s level of interest and dedication to the cause of preventing falls was what determined the extent to which they were involved. It may be difficult to expand quality improvement initiatives beyond the immediate contexts that may be influenced by members of a workgroup. We aim to re-engage with clinical leadership at our institution once we have completed our initial review and can share our findings and outline future actions for dissemination and implementation (Ganz et al., 2019).
Was there improvement and if so, was the improvement sustained?
This approach to the development of the program is showing early signs of being sustainable. The interdisciplinary working group has been holding regular meetings since since it was first organized. In order to generate goodwill and the opportunity to improve the program over time in accordance with the principles of continuous quality improvement, the objective of the program development process was to create an initial effort that was sustainable enough to demonstrate a small success to our organization. According to these standards, we consider the first stage of the product development process to have been a successful one (Ganz et al., 2019).
Discuss what additional or alternative quality improvement methods, implementation science approaches, and framework you would have used or recommended.
By implementing prevention measures, conducting multifactoral risk assessments and screenings, implementing post-fall care approaches, and making suggestions for practice. Also, the provision of a protocol will serve as a practice guideline to advise health care practitioners on the best practices for implementing patient fall prevention and management programs in hospital and community settings. These programs may be found in both settings. The ultimate goal of improving evidence-based culture and bridging the gap between theory and practice is to sustain high-quality patient care. This will also help to ensure that patients receive safe treatment (General Department of Nursing, 2021).
Describe two key takeaways from this article that you would incorporate into a similar quality improvement project in the future:
Working together as a team to plan and carry out the execution of the solutions.
Continue to evaluate the effectiveness of the program and make adjustments as necessary.
References
Ganz, D. A., Yano, E. M., Saliba, D., & Shekelle, P. G. (2019). Design of a continuous quality improvement program to prevent falls among community-dwelling older adults in an integrated healthcare system. BMC Health Services Research, 9(1).
General Department of Nursing. (2021). General Department of Nursing, PATIENT FALLS PREVENTION AND MANAGEMENT A CLINICAL GUIDELINE FOR NURSES.
Koczwara, B., Stover, A. M., Davies, L., Davis, M. M., Fleisher, L., Ramanadhan, S., Schroeck, F. R., Zullig, L. L., Chambers, D. A., & Proctor, E. (2018). Harnessing the Synergy Between Improvement Science and Implementation Science in Cancer: A Call to Action. Journal of Oncology Practice, 14(6), 335–340.
Leeman, J., Rohweder, C., Lee, M., Brenner, A., Dwyer, A., Ko, L. K., O’Leary, M. C., Ryan, G., Vu, T., & Ramanadhan, S. (2021). Aligning implementation science with improvement practice: a call to action. Implementation Science Communications, 2(1).
Wensing, M. (2015). Implementation science in healthcare: Introduction and perspective. Zeitschrift Für Evidenz, Fortbildung Und Qualität Im Gesundheitswesen, 109(2), 97–102.
this is qoustion was For this week’s discussion, use the Saudi Digital Library to locate a scholarly journal article that details the use of implementation science to advance quality improvement in healthcare.
Summarize the article to include the healthcare setting, the quality initiative, the methodology, and outcomes.
Was there a framework used to guide the implementation?
Did the author(s) describe any barriers to implementation?
Was there improvement and if so, was the improvement sustained?
Discuss what additional or alternative quality improvement methods, implementation science approaches, and framework you would have used or recommended.
Describe two key takeaways from this article that you would incorporate into a similar quality improvement project in the future.
Expert Solution Preview
The article by Ganz et al. (2019) discusses a continuous quality improvement program aimed at preventing falls among community-dwelling older adults in the Veterans Affairs Grinieater Los Angeles Healthcare System (VAGLAHS). The program was developed using various theories and methods, including organizational theory and diffusion of innovations theory. The authors utilized an interdisciplinary working group to develop and execute the program, which included a nurse advice line to analyze fall risk factors and route patients to appropriate resources. The program was monitored and improved monthly by the workgroup.
The authors described resistance to the implementation of the program due to pressure from above, but individual levels of interest and dedication ultimately determined involvement. However, the program showed early signs of sustainability and success, as it has been regularly monitored and adjusted.
Additional quality improvement methods could include prevention measures and post-fall care approaches, while implementation science approaches could involve conducting multifactorial risk assessments and screenings. A recommended framework could include a protocol to guide healthcare practitioners in implementing patient fall prevention and management programs in hospital and community settings.
Two key takeaways from this article include the importance of working together as a team to plan and execute solutions, as well as continually evaluating program effectiveness and making necessary adjustments.
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