Evaluation of the implementation of a best practice gestational diabetes model of care in two Australian metropolitan services.

Introduction and aims: Dissemination and local adaptation of best practice models of care are often poorly achieved in knowledge translation processes. Understanding and documenting the iterative cycles of improvement can elucidate barriers, enablers and benefits of the process for future adoption a...

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Publicado en:JBI Evidence Implementation Vol. 20; no. 1; pp. 10 - 21
Autores principales: Wilkinson, Shelley A. AdvAPD, Palmer, Michelle AdvAPD
Formato: research tables/charts Journal Article
Publicado: Lippincott Williams & Wilkins Mar2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2022
      vid: 20
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        atl: Evaluation of the implementation of a best practice gestational diabetes model of care in two Australian metropolitan services.
      aug:
        au:
          Wilkinson, Shelley A. AdvAPD
          Palmer, Michelle AdvAPD
      sug:
        subj:
          Diabetes Mellitus, Gestational
          Patient Care
          Models, Theoretical
          Program Implementation Evaluation
          Urban Areas Australia
          Health Services Australia
          Australia
          Human
          Implementation Science
          Multidisciplinary Care Team
          Medical Practice, Evidence-Based
          Nutrition Services
      ab: Introduction and aims: Dissemination and local adaptation of best practice models of care are often poorly achieved in knowledge translation processes. Understanding and documenting the iterative cycles of improvement can elucidate barriers, enablers and benefits of the process for future adoption and service integration improvements. This project examined the process of local adaptation for a third stage translation of a gestational diabetes dietetic model of care through collaboration with two Queensland (Australia) hospitals. Methods: Using a hub (research team)-spoke (sites) model, two Queensland Hospital and Health Service Districts were supported to assess and address evidence-practice dietetic model of care gaps in their gestational diabetes mellitus (GDM) services. Sites selected demonstrated strong GDM team cohesiveness and project commitment. The project phases were: Consultation; Baseline; Transition; Implementation; and Evaluation. Results: Despite strong site buy-in and use of a previously successful model of care dissemination and adoption strategy, unexpected global, organisational, team and individual barriers prevented successful implementation of the model of care at both sites. Barriers included challenges with ethics and governance requirements for health service research, capacity to influence and engage multidisciplinary teams, staff turnover and coronavirus disease 2019's (COVID-19's) disruption to service delivery. Conclusion: This third iteration of the dissemination of a best practice model of nutrition care for GDM in two Queensland Hospital and Health Service Districts did not achieve successful clinical or process outcomes. However, valuable learnings and recommendations regarding future clinical and research health service redesign aligned with best practice are suggested.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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