Beyond barriers and facilitators: the central role of practical knowledge and informal networks in implementing infection prevention interventions
Year: 2018
Type: article
Abstract: An enduring challenge for the improvement of healthcare quality is variation in the success of quality improvement (QI) interventions when implemented across settings.1 This is particularly true in the field of healthcare-associated infection (HAI) prevention. Some of the brightest success stories in QI have emerged from large-scale efforts to reduce HAIs such as central venous catheter-related bloodstream infections (CRBSIs)2 or catheter-associated urinary tract infections.3 The light dims, however, when efforts to export these interventions to other settings fail to meaningfully improve outcomes.4 5
To make sense of this phenomenon, attention must be paid to the social, organisational, economic, and cultural factors that may shape the observed associations between interventions and their outcomes.1 6–8 These factors are components of context, which is a key modifier of the impact of QI interventions.9–11 Understanding how context influences interventions is of critical importance to advancing the science of QI. Yet studying context is challenging9 12 13 The definition of context in QI has evolved in recent years, but remains broad: ‘the physical and sociocultural make-up of the local environment (eg, external environmental factors, organisational dynamics, collaboration, resources, leadership and the like), and the interpretation of these factors (“sense-making”) by the healthcare delivery professionals, patients and caregivers that can affect …
Source: BMJ Quality & Safety
Author: Julia E Szymczak
Institution: University of Pennsylvania
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2884201127