Shifting Implementation Science Theory to Empower Primary Care Practices.
Observers of the past 10 to 15 years have witnessed the simultaneous growth of dramatic changes in the practice of primary care and the emergence of a new field of dissemination and implementation science (D&I). Most current implementation science research in primary care assumes practices are not m...
| Publicado en: | Annals of Family Medicine Vol. 17; no. 3; pp. 250 - 257 |
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| Autores principales: | , , , |
| Formato: | Journal Article |
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Annals of Family Medicine
May/Jun2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=136361027&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 136361027 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15441709 QMD jtl: Annals of Family Medicine issn: 15441709 maglogo: N pubinfo: dt: May/Jun2019 vid: 17 iid: 3 pid: 15913 pub: Annals of Family Medicine place: Leawood, Kansas artinfo: ui: 136361027 136361027 NLM31085529 10.1370/afm.2353 NLM31085529 136361027 ppf: 250 ppct: 7 formats: tig: atl: Shifting Implementation Science Theory to Empower Primary Care Practices. aug: au: Miller, William L. Rubinstein, Ellen B. Howard, Jenna Crabtree, Benjamin F. affil: Lehigh Valley Health Network/University of South Florida Morsani College of Medicine, Allentown, Pennsylvania sug: subj: Primary Health Care Standards Health Services Research Qualitative Studies Primary Health Care Trends Primary Health Care Economics Ferrans and Powers Quality of Life Index ab: Observers of the past 10 to 15 years have witnessed the simultaneous growth of dramatic changes in the practice of primary care and the emergence of a new field of dissemination and implementation science (D&I). Most current implementation science research in primary care assumes practices are not meeting externally derived standards and need external support to meet these demands. After a decade of initiatives, many stakeholders now question the return on their investments. Overall improvements in quality metrics, utilization cost savings, and patient experience have been less than anticipated. While recently conducting a research project in primary care practices, we unexpectedly discovered 3 practices that profoundly shifted our thinking about the sources and directionality of practice change and the underlying assumptions of D&I. Inspired by these practices-along with systems thinking, complexity theory, action research, and the collaborative approaches of community-based participatory research-we propose a reimagining of D&I theory to empower practices. We shift the emphasis regarding the source and direction of change from outside-in to inside-out Such a shift has the potential to open a new frontier in the science of dissemination and implementation and inform better health policy. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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