A qualitative study to identify barriers and facilitators to implementation of pilot interventions in the Veterans Health Administration (VHA) Northwest Network.

Objective: To identify barriers and facilitators to implementation of pilot interventions designed to improve measurement and management of low-density lipoprotein cholesterol (LDL-c) levels in coronary heart disease patients using the evidence/context/facilitation model of implementation of evidenc...

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Published in:Worldviews on Evidence-Based Nursing (Wiley-Blackwell) Vol. 1; no. 2; pp. 129 - 140
Main Authors: Sharp ND, Pineros SL, Hsu C, Starks H, Sales AE
Format: research tables/charts Journal Article
Published: Wiley-Blackwell 2004 2nd Quarter
Online Access:View this record in EBSCOhost
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      dt: 2004 2nd Quarter
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        106606383
        18353330
        2005064313
        10.1111/j.1741-6787.2004.04023.x
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        atl: A qualitative study to identify barriers and facilitators to implementation of pilot interventions in the Veterans Health Administration (VHA) Northwest Network.
      aug:
        au:
          Sharp ND
          Pineros SL
          Hsu C
          Starks H
          Sales AE
        affil: Va Puget Sound Health Care System (152), Seattle, WA 98108; Nancy.Sharp@med.va.gov
      sug:
        subj:
          Hypercholesterolemia Therapy
          Lipoproteins, LDL Blood
          Myocardial Ischemia
          Program Implementation Evaluation
          Content Analysis
          Health Personnel
          Professional Practice, Evidence-Based
          Qualitative Studies
          Structured Interview
          United States
          United States Department of Veterans Affairs
          Human
      ab: Objective: To identify barriers and facilitators to implementation of pilot interventions designed to improve measurement and management of low-density lipoprotein cholesterol (LDL-c) levels in coronary heart disease patients using the evidence/context/facilitation model of implementation of evidence-based practice.Design: Theory-based conceptual content analysis of structured interviews conducted between January and April 2001.Setting: Six medical centers in the United States Veterans Health Administration Northwest Network.Participants: Fifty-one of 64 individuals (physicians, nurses, pharmacists, dieticians, quality managers, and other clinical and nonclinical staff) who participated in planning and/or implementing pilot interventions.Main Findings: Barriers to successful implementation related primarily to the intervention process and secondarily to characteristics of the intervention context. Interview responses indicated that planning, including identification of resources and assessment of potential barriers and facilitators, was a critical and universally underutilized step in the intervention process.Conclusions: Organized team process, documented plans for intervention activities, and ongoing evaluation are essential for sustaining intervention activities. A top priority for facilitating interventions should be the development of educational materials, such as 'how to' guides, that teach intervention teams how to anticipate barriers and make plans to address them, as well as identifying and fostering local experts in planning and implementing interventions.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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