81 A rapid-cycle application of the Consolidated Framework for Implementation Research allows timely identification of barriers and facilitators to implementing the World Health Organization’s Emergency Care Toolkit in Zambia

IF 2.1 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Journal of Clinical and Translational Science Pub Date : 2024-04-03 DOI:10.1017/cts.2024.82
Taylor Burkholder, Julia Dixon, Morgan Broccoli, Natasha Chenga, Patricia Chibesakunda, Winnie Kunda, Kephas E Mwanza, James Nonde, Mwiche Chiluba
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Abstract

OBJECTIVES/GOALS: Implementation science evaluations are often too time-intensive to provide actionable feedback during implementation, suggesting the need for more agile methods. We present an evaluation of the World Health Organization’s Emergency Care Toolkit implementation in Zambia using rapid qualitative methods to provide timely feedback. METHODS/STUDY POPULATION: We evaluated the implementation of the Emergency Care Toolkit in eight general and referral hospitals in Zambia in 2023 using a rapid-cycle, qualitative template analysis approach grounded in the Consolidated Framework for Implementation Research (CFIR). We gathered qualitative data from operational field notes, focus groups, and key informant interviews of administrators, clinicians, nurses, and support staff in all eight hospitals in Zambia. We parsimoniously applied CFIR constructs and tool-specific codes, focused on barriers and facilitators, to allow for rapid but comprehensive cross-case analysis. The results were used to generate a matrix of stakeholder-relevant, plain-language barriers and facilitators for each tool. RESULTS/ANTICIPATED RESULTS: We completed eight site visits with focus groups and interviews following initial implementation in September 2023 to gather firsthand knowledge related to implementation of the Toolkit. The CFIR-focused coding accelerated analysis by centering on barriers and facilitators for each tool while maintaining a comprehensive evaluation framework. Summary tables of barriers and facilitators were easily interpreted by lay stakeholders. Visualization in tables allowed for identification of common themes across tools and hospitals, making comprehensive recommendations to the implementation and dissemination process quickly possible. We anticipate the study findings will empower implementing partners to make timely, actionable improvements. DISCUSSION/SIGNIFICANCE: Rapid-cycle qualitative implementation evaluations allow for rigorous yet timely feedback on the implementation process compared to traditional methods. This efficient strategy is particularly important in resource-constrained environments where inefficient implementation wastes limited resources and create delays that cost lives.
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81 实施研究综合框架的快速循环应用可及时查明在赞比亚实施世界卫生组织紧急护理工具包的障碍和促进因素
目标:实施科学评估往往耗时过长,无法在实施过程中提供可操作的反馈,这表明需要更灵活的方法。我们采用快速定性方法对世界卫生组织在赞比亚实施的紧急救护工具包进行了评估,以提供及时反馈。方法/研究对象:我们采用基于实施研究综合框架(CFIR)的快速循环定性模板分析方法,对 2023 年在赞比亚八家综合医院和转诊医院实施急诊工具包的情况进行了评估。我们从现场操作记录、焦点小组以及对赞比亚所有八家医院的管理人员、临床医生、护士和辅助人员进行的关键信息提供者访谈中收集定性数据。我们采用了简化的 CFIR 结构和工具特定代码,重点关注障碍和促进因素,以便进行快速而全面的跨案例分析。分析结果被用于为每种工具生成与利益相关者相关的、通俗易懂的障碍和促进因素矩阵。结果/预期结果:在 2023 年 9 月初步实施后,我们完成了八次实地考察,并进行了焦点小组和访谈,以收集与工具包实施相关的第一手资料。在保持全面评估框架的同时,以 CFIR 为中心的编码加快了分析速度,将重点放在每个工具的障碍和促进因素上。障碍和促进因素汇总表很容易被非专业的利益相关者解读。表格的可视化使我们能够识别不同工具和医院的共同主题,从而迅速为实施和推广过程提出全面建议。我们预计研究结果将使实施伙伴能够及时做出可行的改进。讨论/意义:与传统方法相比,快速周期定性实施评估可以对实施过程进行严格而及时的反馈。在资源有限的环境中,这种高效的策略尤为重要,因为低效的实施会浪费有限的资源,造成延误,从而导致生命损失。
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来源期刊
Journal of Clinical and Translational Science
Journal of Clinical and Translational Science MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
2.80
自引率
26.90%
发文量
437
审稿时长
18 weeks
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