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      Implementationsforschung: Grundbegriffe und Konzepte

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          Abstract

          Die Implementationsforschung operationalisiert Schritte einer erfolgreichen Umsetzung von Forschungsergebnissen. Im vorliegenden Beitrag wird das Konzept der Implementationsforschung jenseits von Konzepten der praktischen Umsetzung und der erzielten Evaluationsergebnisse betrachtet. Hierzu wird eine Taxonomie von acht konzeptionell unterscheidbaren Outcomeparametern vorgeschlagen: Akzeptanz, Übernahme, Angemessenheit, Machbarkeit, Wiedergabetreue, Kosten, Durchdringung und Nachhaltigkeit. Das Konzeptualisieren und Ermitteln von Implementationsergebnissen tragen dazu bei, die Effizienz der Implementationsforschung zu erhöhen und den Weg für ein besseres Verständnis von Umsetzungsstrategien zu ebnen.

          Implementation research: Basic concepts

          Implementation research operationalizes the steps required for the successful implementation of research findings. This article will examine the concepts of practical implementation and evaluation results independently. For this purpose a taxonomy of eight conceptually distinct outcome parameters of implementation is proposed: acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration, and sustainability. Determining and measuring implementation outcomes contribute to increasing the efficiency of implementation research and pave the way for a better understanding of implementation strategies.

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          Most cited references27

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          Mental health provider attitudes toward adoption of evidence-based practice: the Evidence-Based Practice Attitude Scale (EBPAS).

          Mental health provider attitudes toward organizational change have not been well studied. Dissemination and implementation of evidence-based practices (EBPs) into real-world settings represent organizational change that may be limited or facilitated by provider attitudes toward adoption of new treatments, interventions, and practices. A brief measure of mental health provider attitudes toward adoption of EBPs was developed and attitudes were examined in relation to a set of provider individual difference and organizational characteristics. Participants were 322 public sector clinical service workers from 51 programs providing mental health services to children and adolescents and their families. Four dimensions of attitudes toward adoption of EBPs were identified: (1) intuitive Appeal of EBP, (2) likelihood of adopting EBP given Requirements to do so, (3) Openness to new practices, and (4) perceived Divergence of usual practice with research-based/academically developed interventions. Provider attitudes varied by education level, level of experience, and organizational context. Attitudes toward adoption of EBPs can be reliably measured and vary in relation to individual differences and service context. EBP implementation plans should include consideration of mental health service provider attitudes as a potential aid to improve the process and effectiveness of dissemination efforts.
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            Toward evidence-based quality improvement. Evidence (and its limitations) of the effectiveness of guideline dissemination and implementation strategies 1966-1998.

            To determine effectiveness and costs of different guideline dissemination and implementation strategies. MEDLINE (1966 to 1998), HEALTHSTAR (1975 to 1998), Cochrane Controlled Trial Register (4th edn 1998), EMBASE (1980 to 1998), SIGLE (1980 to 1988), and the specialized register of the Cochrane Effective Practice and Organisation of Care group. Randomized-controlled trials, controlled clinical trials, controlled before and after studies, and interrupted time series evaluating guideline dissemination and implementation strategies targeting medically qualified health care professionals that reported objective measures of provider behavior and/or patient outcome. Two reviewers independently abstracted data on the methodologic quality of the studies, characteristics of study setting, participants, targeted behaviors, and interventions. We derived single estimates of dichotomous process variables (e.g., proportion of patients receiving appropriate treatment) for each study comparison and reported the median and range of effect sizes observed by study group and other quality criteria. We included 309 comparisons derived from 235 studies. The overall quality of the studies was poor. Seventy-three percent of comparisons evaluated multifaceted interventions. Overall, the majority of comparisons (86.6%) observed improvements in care; for example, the median absolute improvement in performance across interventions ranged from 14.1% in 14 cluster-randomized comparisons of reminders, 8.1% in 4 cluster-randomized comparisons of dissemination of educational materials, 7.0% in 5 cluster-randomized comparisons of audit and feedback, and 6.0% in 13 cluster-randomized comparisons of multifaceted interventions involving educational outreach. We found no relationship between the number of components and the effects of multifaceted interventions. Only 29.4% of comparisons reported any economic data. Current guideline dissemination and implementation strategies can lead to improvements in care within the context of rigorous evaluative studies. However, there is an imperfect evidence base to support decisions about which guideline dissemination and implementation strategies are likely to be efficient under different circumstances. Decision makers need to use considerable judgment about how best to use the limited resources they have for quality improvement activities.
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              Beyond usability: designing effective technology implementation systems to promote patient safety

              B-T Karsh (2004)
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                Author and article information

                Journal
                pru
                Psychologische Rundschau
                Hogrefe Verlag, Göttingen
                0033-3042
                2190-6238
                Juli 2014
                : 65
                : 3
                : 122-128
                Author notes
                Prof. Dr. Franz Petermann, Universität Bremen, Zentrum für Klinische Psychologie und Rehabilitation, Grazer Straße 6, 28359 Bremen, E-Mail: fpeterm@ 123456uni-bremen.de
                Article
                pru_65_3_122
                10.1026/0033-3042/a000214
                38b6c22c-e64c-40cb-8bd2-0ac95b3d5d87
                Copyright @ 2014
                History
                Categories
                Originalia

                Psychology
                fidelity,sustainability.,Implementationsforschung,Kosten,Nachhaltigkeit,Wiedergabetreue.,implementation research,cost

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