An analysis of adaptations to multi-level intervention strategies to enhance implementation of clinical practice guidelines for treating tobacco use in dental care settings

Shelley, Donna; Kyriakos, Christina N; Campo, A.; Li, Y.; Khalife, Dalia; Ostroff, Jamie S.

doi:10.1016/j.conctc.2018.07.003

Cited by 4 publications

(3 citation statements)

References 35 publications

(41 reference statements)

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“…A total of 45 separate CDSSs were reported in the 42 articles included as shown in Table 2 . The most commonly reported CDSSs were electronic prescribing or order sets (12/42, 29%) [ 65 , 69 , 70 , 75 , 76 , 79 - 81 , 83 , 88 , 94 , 98 ], followed by checklists, forms, or clinical guidelines (11/42, 26%) [ 63 , 66 , 73 , 82 , 89 , 92 , 93 , 95 , 102 , 104 ] and electronic alerts or reminders (9/42, 21%) [ 67 , 68 , 77 , 78 , 84 , 86 , 91 , 100 , 101 ]. Commonly, CDSSs were implemented in pharmacy or prescription services (17/42, 41%).…”

Section: Resultsmentioning

confidence: 99%

“…Most studies (24/42, 57%) reported the rationale for using a theory, model, or framework. The rationales reported included the formulation of knowledge or research questions [ 69 , 97 ]; addressing implementation factors leading to the use of CDSSs; and developing an implementation plan, including addressing modifications to an intervention [ 92 , 93 , 100 ]. Others cited the existing use or development of a theory, model, or framework [ 85 , 86 , 104 ] and the use of theory in aiding the scalability of intervention in different settings [ 74 , 77 ].…”

Section: Resultsmentioning

confidence: 99%

“…Studies that reported on the strengths of applying a specific theory, model, or framework referred to the lessons learned [ 80 , 90 , 97 ], implementation plans developed [ 102 ], ability to address barriers and facilitators for implementation within the intervention [ 92 , 94 ], adaptability of an intervention or increased scale-up [ 72 , 74 , 93 ], buy-in from stakeholders [ 65 , 76 ], use of interdisciplinary knowledge [ 64 ], and synergy with other implementation tools such as the ERIC [ 100 ].…”

Section: Resultsmentioning

confidence: 99%

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Using Theories, Models, and Frameworks to Inform Implementation Cycles of Computerized Clinical Decision Support Systems in Tertiary Health Care Settings: Scoping Review

Fernando,

Abell,

Tyack

et al. 2023

J Med Internet Res

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Background Computerized clinical decision support systems (CDSSs) are essential components of modern health system service delivery, particularly within acute care settings such as hospitals. Theories, models, and frameworks may assist in facilitating the implementation processes associated with CDSS innovation and its use within these care settings. These processes include context assessments to identify key determinants, implementation plans for adoption, promoting ongoing uptake, adherence, and long-term evaluation. However, there has been no prior review synthesizing the literature regarding the theories, models, and frameworks that have informed the implementation and adoption of CDSSs within hospitals. Objective This scoping review aims to identify the theory, model, and framework approaches that have been used to facilitate the implementation and adoption of CDSSs in tertiary health care settings, including hospitals. The rationales reported for selecting these approaches, including the limitations and strengths, are described. Methods A total of 5 electronic databases were searched (CINAHL via EBSCOhost, PubMed, Scopus, PsycINFO, and Embase) to identify studies that implemented or adopted a CDSS in a tertiary health care setting using an implementation theory, model, or framework. No date or language limits were applied. A narrative synthesis was conducted using full-text publications and abstracts. Implementation phases were classified according to the “Active Implementation Framework stages”: exploration (feasibility and organizational readiness), installation (organizational preparation), initial implementation (initiating implementation, ie, training), full implementation (sustainment), and nontranslational effectiveness studies. Results A total of 81 records (42 full text and 39 abstracts) were included. Full-text studies and abstracts are reported separately. For full-text studies, models (18/42, 43%), followed by determinants frameworks (14/42,33%), were most frequently used to guide adoption and evaluation strategies. Most studies (36/42, 86%) did not list the limitations associated with applying a specific theory, model, or framework. Conclusions Models and related quality improvement methods were most frequently used to inform CDSS adoption. Models were not typically combined with each other or with theory to inform full-cycle implementation strategies. The findings highlight a gap in the application of implementation methods including theories, models, and frameworks to facilitate full-cycle implementation strategies for hospital CDSSs.

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