A Perspective on Implementation Outcomes and Strategies to Promote the Uptake of COVID-19 Vaccines

Abstract

Recent articles have highlighted the importance of incorporating implementation science concepts into pandemic-related research. However, limited research has been documented to date regarding implementation outcomes that may be unique to COVID-19 vaccinations and how to utilize implementation strategies to address vaccine program-related implementation challenges. To address these gaps, we formed a global COVID-19 implementation workgroup of implementation scientists who met weekly for over a year to review the available literature and learn about ongoing research during the pandemic. We developed a hierarchy to prioritize the applicability of “lessons learned” from the vaccination-related implementation literature. We identified applications of existing implementation outcomes as well as identified additional implementation outcomes. We also mapped implementation strategies to those outcomes. Our efforts provide rationale for the utility of using implementation outcomes in pandemic-related research. Furthermore, we identified three additional implementation outcomes: availability, health equity, and scale-up. Results include a list of COVID-19 relevant implementation strategies mapped to the implementation outcomes.

The COVID‐19 Pandemic's impact on sustainability and expansion of a Pediatric Early Warning System in resource‐limited hospitals

“…Our study similarly only evaluated the pandemic's impact on the sustainability and scale of one intervention at pediatric oncology hospitals, potentially limiting generalizability to other interventions and settings. However, our findings are supported by literature from other settings and can inform global strategies to promote sustainability of other QI programs 24,34,35 . While this study lays the foundation for future work regarding PEWS, factors influencing long‐term sustainability of interventions like PEWS across large cohort of resource‐limited centers post‐pandemic and its subsequent impact on patient outcomes should be explored in future research 9 …”

“…Specific recommendations informed by this work include prioritizing assessment of existing material resources and communicating relevant resource needs to leadership, communicating the benefits and reason for maintaining the program to engage staff and hospital leaders, and proactively identifying and addressing sustainability challenges. 24 Collaborating internally within hospitals and externally through hospital collaboratives (such as in Proyecto EVAT) can facilitate sharing of strategies to promote maintenance of effective interventions during health crises. Beyond sustainability, this work identified the scale, or expansion of PEWS, as a characteristic of this initiative interrupted by the pandemic.…”

“…Findings of this study can guide clinicians and researchers looking to maintain effective QI programs during future stressors that limit resources and staff available for programmatic support. Specific recommendations informed by this work include prioritizing assessment of existing material resources and communicating relevant resource needs to leadership, communicating the benefits and reason for maintaining the program to engage staff and hospital leaders, and proactively identifying and addressing sustainability challenges 24 …”

“…Specific recommendations informed by this work include prioritizing assessment of existing material resources and communicating relevant resource needs to leadership, communicating the benefits and reason for maintaining the program to engage staff and hospital leaders, and proactively identifying and addressing sustainability challenges. 24 …”

“…Our previous work described barriers to and enablers of PEWS implementation in resource‐limited hospitals prior to the start of the COVID‐19 23 . Health system disruptions, however, may create additional barriers to continued PEWS use in these settings 24 . This study evaluates the impact of the pandemic on an ongoing QI program, PEWS, in resource‐limited pediatric oncology hospitals in Latin America and explores factors that impact programmatic sustainability and expansion.…”