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Abstract

Implementation research is the scientific study of methods to promote the systematic uptake of research findings and other evidence-based practices into routine practice, and, hence, to improve the quality and effectiveness of health services and care. This relatively new field includes the study of influences on healthcare professional and organisational behaviour.

Implementation Science will encompass all aspects of research in this field, in clinical, community and policy contexts. This online journal will provide a unique platform for this type of research and will publish a broad range of articles – study protocols, debate, theoretical and conceptual articles, rigorous evaluations of the process of change, and articles on methodology and rigorously developed tools – that will enhance the development and refinement of implementation research. No one discipline, research design, or paradigm will be favoured.

Implementation Science looks forward to receiving manuscripts that facilitate the continued development of the field, and contribute to healthcare policy and practice.

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Most cited references 5

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The quality of health care delivered to adults in the United States.

Elizabeth A McGlynn, Steven M Asch, John P.P. Adams … (2003)

We have little systematic information about the extent to which standard processes involved in health care--a key element of quality--are delivered in the United States. We telephoned a random sample of adults living in 12 metropolitan areas in the United States and asked them about selected health care experiences. We also received written consent to copy their medical records for the most recent two-year period and used this information to evaluate performance on 439 indicators of quality of care for 30 acute and chronic conditions as well as preventive care. We then constructed aggregate scores. Participants received 54.9 percent (95 percent confidence interval, 54.3 to 55.5) of recommended care. We found little difference among the proportion of recommended preventive care provided (54.9 percent), the proportion of recommended acute care provided (53.5 percent), and the proportion of recommended care provided for chronic conditions (56.1 percent). Among different medical functions, adherence to the processes involved in care ranged from 52.2 percent for screening to 58.5 percent for follow-up care. Quality varied substantially according to the particular medical condition, ranging from 78.7 percent of recommended care (95 percent confidence interval, 73.3 to 84.2) for senile cataract to 10.5 percent of recommended care (95 percent confidence interval, 6.8 to 14.6) for alcohol dependence. The deficits we have identified in adherence to recommended processes for basic care pose serious threats to the health of the American public. Strategies to reduce these deficits in care are warranted. Copyright 2003 Massachusetts Medical Society

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Disseminating health information in developing countries: the role of the internet.

T Edejer (2000)

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Systematic review of studies of quality of clinical care in general practice in the UK, Australia and New Zealand.

M E Seddon, M N Marshall, S M Campbell … (2001)

Little is known about the quality of clinical care provided outside the hospital sector, despite the increasingly important role of clinical generalists working in primary care. In this study we aimed to summarise published evaluations of the quality of clinical care provided in general practice in the UK, Australia, and New Zealand. A systematic review of published studies assessing the quality of clinical care in general practice for the period 1995-9. General practice based care in the UK, Australia, and New Zealand. Main outcome measures-Study design, sampling strategy and size, clinical conditions studied, quality of care attained for each condition (compared with explicit or implicit standards for the process of care), and country of origin for each study. Ninety papers fulfilled the entry criteria for the review, 80 from the UK, six from Australia, and four from New Zealand. Two thirds of the studies assessed care in self-selected practices and 20% of the studies were based in single practices. The majority (85.5%) examined the quality of care provided for chronic conditions including cardiovascular disease (22%), hypertension (14%), diabetes (14%), and asthma (13%). A further 12% and 2% examined preventive care and acute conditions, respectively. In almost all studies the processes of care did not attain the standards set out in national guidelines or those set by the researchers themselves. For example, in the highest achieving practices 49% of diabetic patients had had their fundii examined in the previous year and 47% of eligible patients had been prescribed beta blockers after an acute myocardial infarction. This study adopts an overview of the magnitude and the nature of clinical quality problems in general practice in three countries. Most of the studies in the systematic review come from the UK and the small number of papers from Australia and New Zealand make it more difficult to draw conclusions about the quality of care in these two countries. The review helps to identify deficiencies in the research, clinical and policy agendas in a part of the health care system where quality of care has been largely ignored to date. Further work is required to evaluate the quality of clinical care in a representative sample of the population, to identify the reasons for substandard care, and to test strategies to improve the clinical care provided in general practice.

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Journal

Journal ID (nlm-ta): Implement Sci

Title: Implementation Science

Publisher: BioMed Central (London )

ISSN (Electronic): 1748-5908

Publication date Collection: 2006

Publication date (Electronic): 22 February 2006

Volume: 1

Page: 1

Affiliations

[1 ]Centre for Health Services Research, University of Newcastle, Newcastle upon Tyne, UK

[2 ]VA Center for the Study of Healthcare Provider Behavior, VA Greater Los Angeles Healthcare System, Sepulveda, California, USA

[3 ]Department of Health Services, UCLA School of Public Health, Los Angeles, California, USA

Article

Publisher ID: 1748-5908-1-1

DOI: 10.1186/1748-5908-1-1

PMC ID: 1436009

PubMed ID: 17118180

SO-VID: 69368e1c-d401-4edd-876d-2ea9d0990ee1

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Welcome to Implementation Science

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Most cited references 5

The quality of health care delivered to adults in the United States.

Disseminating health information in developing countries: the role of the internet.

Systematic review of studies of quality of clinical care in general practice in the UK, Australia and New Zealand.

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