Decommissioning health care

"Decommissioning – defined as the planned process of removing, reducing or replacing health-care services – is an important component of current reforms in the NHS. This study aims to formulate theoretically grounded, evidence-informed guidance to support best practice in effective decommissioning of NHS services. Decommissioning is shaped by change management and implementation, evidence and information, and relationships and politics. We propose an expanded understanding, encompassing organisational and political factors, of how avoidance of loss affects the delivery of decommissioning programmes. Future work should explore the relationships between contexts, mechanisms and outcomes in decommissioning, develop the understanding of how loss affects decisions and explore the long-term impact of decommissioning and its impact on patient care and outcomes."

Decommissioning health care: identifying best practice through primary and secondary research a prospective mixed-methods study
I Williams, J Harlock, G Robert, R Mannion, S Brearley, K Hall
Health Services and Delivery Research, 2017, 5:22

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Improving the health of the public by 2040

"Over the coming decades, the UK population will face a wide range of complex health challenges and opportunities, many of which can only be fully addressed through strategies to secure and improve the health of the public as a whole. This report explores how to organise our research environment to generate and translate the evidence needed to underpin such strategies."

Improving the health of the public by 2040: Optimising the research environment for a healthier, fairer future
The Academy of Medical
September 2016

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Strengthening population health intervention

"Much of the research and theorising in the knowledge translation (KT) field has focused on clinical settings, providing little guidance to those working in community settings. In this study, we build on previous research in community-based KT by detailing the theory driven and empirically-informed CollaboraKTion framework."

Strengthening population health intervention: developing the CollaboraKTion Framework for community-based knowledge translation
EK Jenkins, A Kothari, V Bungay, JL Johnson, JL Oliffe
Health Research Policy and Systems, 2016, 14:65

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Embedding research in health systems: lessons from complexity theory

"We argue for the need to study how micro-processes of organisational dynamics may give rise to macro patterns of behaviour and strategic organisational direction and for the use of systems approaches to investigate the emergent properties of health research systems."

Embedding research in health systems: lessons from complexity theory
L Caffrey, C Wolfe, C McKevitt
Health Research Policy and Systems, 2016, 14:54

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Sustainability of knowledge translation interventions in healthcare decision-making

"We found few studies focusing on the sustainability of KT interventions. Most of the included studies focused on patient-level outcomes and patient-level KT interventions. A future systematic review can be conducted of the RCTs to examine the impact of sustainable KT interventions on health outcomes."

Sustainability of knowledge translation interventions in healthcare decision-making: a scoping review
AC Tricco, et al.
Implementation Science, 2016, 11:55

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Achieving change in primary care

"Conclusions There is a substantial literature on implementation strategies aimed at changing professional practices or behaviour. It remains unclear which implementation strategies are more likely to be effective than others and under what conditions. Future research should focus on identifying and assessing the effectiveness of strategies targeted at the wider context and organisational levels and examining the costs and cost-effectiveness of implementation strategies."

Achieving change in primary care—effectiveness of strategies for improving implementation of complex interventions: systematic review of reviews
R Lau, et al.
BMJ Open, 2015, 5:2009993

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Understanding effective care management implementation in primary care

"Although care management can introduce many new changes into the delivery of primary care clinical practice, implementing it successfully as a new complex intervention is possible."

Understanding effective care management implementation in primary care: a macrocognition perspective analysis
JS Holtrop, G Potworowski, L Fitzpatrick, A Kowalk, LA Green
Implementation Science, 2015, 10:122

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Effective strategies for the implementation of care bundles on ICUs

"The three most frequently used strategies were education, reminders and audit and feedback."

What are effective strategies for the implementation of care bundles on ICUs: a systematic review
MJ Borgert, A Goossens, DA Dongelmans
Implementation Science, 2015, 10:119

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Effectiveness of short stay programmes for breast cancer surgery

"We provided a detailed case description of how implementation costs can be determined. Notable differences in implementation costs between hospitals were observed."

A detailed report of the resource use and costs associated with implementation of a short stay programme for breast cancer surgery
SMC Ament, et al.
Implementation Science, 2015, 10:78

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Primary health care interventions for Indigenous people with chronic diseases

"Future interventions should consider the findings of this review as it provides an evidence base that contributes to the successful design, implementation and sustainability of chronic disease interventions in primary health care settings intended for Indigenous people."

Enablers and barriers to the implementation of primary health care interventions for Indigenous people with chronic diseases: a systematic review
O Gibson, et al.
Implementation Science, 2015, 10:71

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Enabling local implementation of sustainable urgent and emergency care models

“Efforts should focus on building an effective community offer. This will require adequate investment to transform primary, community and social care – while ensuring that acute and emergency care remains sustainable.”

Rip off the sticking plaster now: Enabling the local implementation of sustainable urgent and emergency care models in 2015/16
NHS Confederation
April 2015

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A Darwinian proposal for health policy and systems research

"We propose that selective ‘breeding’ through successive evaluations of and selection among implementation strategies is a metaphor that health system thinkers can use to improve health care."

Evaluation as evolution: a Darwinian proposal for health policy and systems research
AL Martiniuk, S Abimbola, M Zwarenstein
Health Research Policy and Systems, 2015, 13:15

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Facilitating large-scale implementation of evidence based health care

"The findings provide prospective empirical data on the large scale implementation of EBHC [evidence based health care] in primary care and community based organisations focusing on resources and processes involved. Detailed evidence shows facilitation is context dependent and that ‘one size does not fits all’."

Facilitating large-scale implementation of evidence based health care: insider accounts from a co-operative inquiry
H Waterman, et al.
BMC Health Services Research, 2015, 15:60

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Networked innovation in the health sector

"We further highlight the implications of this analysis for policy and practice by discussing how network structures and boundary-spanning roles and activities can be tailored to different KT objectives."

Networked innovation in the health sector: comparative qualitative study of the role of Collaborations for Leadership in Applied Health Research and Care (CLAHRC) in translating research into practice
H Scarbrough, D D'Andreta, S Evans, M Marabelli, S Newell, J Powell, J Swan
Health Services and Delivery Research, 2014, 2(3)

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Mind the gap between recommendations and implementation

"Using the findings of incident investigations to improve patient safety management is well-established and mandatory under Swedish law. This study seeks to identify the mechanisms behind successful implementation of the recommendations of incident investigations."

Mind the gap between recommendation and implementation—principles and lessons in the aftermath of incident investigations: a semi-quantitative and qualitative study of factors leading to the successful implementation of recommendations
J Wrigstad, J Bergstrom, P Gustafson
BMJ Open, 2014, 4:e005326

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Spreading improvement ideas

"Based on a review of 477 studies, there is evidence that spreading good practice in local internal teams can be facilitated by targeting key individuals, providing focused and proactive training and internal marketing."

No. 20: Spreading improvement ideas: Tips from empirical research
D de Silva
The Health Foundation
May 2014

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Making sense of evidence in management decisions

"Local processes and professional and microsystem considerations played a significant role in adoption and implementation."

Making sense of evidence in management decisions: the role of research-based knowledge on innovation adoption and implementation in health care
Y Kyratsis, R Ahmad, K Hatzaras, M Iwami, A Holmes
HS&DR, 2014, 6(2)

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Commissioning guide: weight assessment and management clinics

"This Tier 3 guidance describes the role of the referring GP, what should be achieved in the clinics and who should be referred for bariatric surgery."

Commissioning guide: weight assessment and management clinics (tier 3)
Royal College of Surgeons (England)
March 2014

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Read a summary from the Commissioning Elf here.

A meta-analysis of how clinicians use decision aids during clinical encounters

"Clinicians' fidelity to usage instructions of point-of-care decision aids in randomized trials was suboptimal during their initial implementation in practice, which may have underestimated the potential efficacy of decision aids when used as intended."

Peering into the black box: a meta-analysis of how clinicians use decision aids during clinal encounters
KD Wyatt, ME Branda, RT Anderson, LJ Pencille, VM Montori, EP Hess, HH Ting, A LeBlanc
Implementation Science, 2014, 9:26

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Managing the transition to the reformed health system

"This report examines how the Department of Health and the NHS implemented the transition from the existing to the reformed health system."

Managing the transition to the reformed health system
National Audit Office
July 2013

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