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Review of implementation strategies to change healthcare provider behaviour in the emergency department

  • Kerstin de Wit (a1) (a2) (a3), Janet Curran (a4), Brent Thoma (a5), Shawn Dowling (a6), Eddy Lang (a6), Nebojsa Kuljic (a7), Jeffrey J. Perry (a8) and Laurie Morrison (a9)...

Abstract

Objectives

Advances in emergency medicine research can be slow to make their way into clinical care, and implementing a new evidence-based intervention can be challenging in the emergency department. The Canadian Association of Emergency Physicians (CAEP) Knowledge Translation Symposium working group set out to produce recommendations for best practice in the implementation of a new science in Canadian emergency departments.

Methods

A systematic review of implementation strategies to change health care provider behaviour in the emergency department was conducted simultaneously with a national survey of emergency physician experience. We summarized our findings into a list of draft recommendations that were presented at the national CAEP Conference 2017 and further refined based on feedback through social media strategies.

Results

We produced 10 recommendations for implementing new evidence-based interventions in the emergency department, which cover identifying a practice gap, evaluating the evidence, planning the intervention strategy, monitoring, providing feedback during implementation, and desired qualities of future implementation research.

Conclusions

We present recommendations to guide future emergency department implementation initiatives. There is a need for robust and well-designed implementation research to guide future emergency department implementation initiatives.

Objectifs

Il peut s’écouler passablement de temps avant que les progrès découlant de la recherche en médecine d’urgence trouvent application en pratique clinique, et la mise en œuvre d’interventions fondées sur des données probantes au service des urgences (SU) peut se révéler une tâche ardue. Le groupe de travail du symposium sur l’application des connaissances de l’Association canadienne des médecins d’urgence (ACMU) a élaboré un ensemble de recommandations concernant les pratiques exemplaires dans la mise en œuvre d’une nouvelle science aux services des urgences au Canada.

Méthode

L’équipe a procédé à une revue systématique des stratégies de mise en œuvre visant à changer le comportement des fournisseurs de soins de santé au SU, menée en parallèle avec une enquête nationale sur l’expérience des médecins d’urgence. Une liste de recommandations préliminaires reposant sur les résultats de la recherche a ensuite été dressée, puis présentée au congrès national de l’ACMU de 2017, après quoi il y a eu amélioration des recommandations d’après les observations recueillies à l’aide de stratégies fondées sur les médias sociaux.

Résultats

Le groupe de travail a élaboré un ensemble de 10 recommandations sur la mise en œuvre de nouvelles interventions fondées sur des données probantes au SU; elles portent sur la reconnaissance des lacunes en matière de pratiques, l’évaluation des données probantes; la planification des stratégies d’intervention, la surveillance et la collecte des réactions durant la mise en œuvre ainsi que sur les qualités que devraient présenter les recherches futures sur la mise en œuvre.

Conclusion

Le groupe a élaboré un ensemble de recommandations visant à guider les initiatives futures de mise en œuvre au SU. Pour ce faire, il faudra mener des recherches de mise en œuvre solides et bien conçues.

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Copyright

Corresponding author

Correspondence to: Dr. Kerstin de Wit, Emergency Department, Hamilton General Hospital, 237 Barton St. East, Hamilton, ON L8L 2X2; Email: dewitk@mcmaster.ca.

References

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