A checklist for identifying determinants of practice: a systematic review and synthesis of frameworks and taxonomies of factors that prevent or enable improvements in healthcare professional practice
Signe A Flottorp, Andrew D Oxman, Jane Krause, Nyokabi R Musila, Michel Wensing, Maciek Godycki-Cwirko, Richard Baker, Martin P Eccles, Signe A Flottorp, Andrew D Oxman, Jane Krause, Nyokabi R Musila, Michel Wensing, Maciek Godycki-Cwirko, Richard Baker, Martin P Eccles
Abstract
Background: Determinants of practice are factors that might prevent or enable improvements. Several checklists, frameworks, taxonomies, and classifications of determinants of healthcare professional practice have been published. In this paper, we describe the development of a comprehensive, integrated checklist of determinants of practice (the TICD checklist).
Methods: We performed a systematic review of frameworks of determinants of practice followed by a consensus process. We searched electronic databases and screened the reference lists of key background documents. Two authors independently assessed titles and abstracts, and potentially relevant full text articles. We compiled a list of attributes that a checklist should have: comprehensiveness, relevance, applicability, simplicity, logic, clarity, usability, suitability, and usefulness. We assessed included articles using these criteria and collected information about the theory, model, or logic underlying how the factors (determinants) were selected, described, and grouped, the strengths and weaknesses of the checklist, and the determinants and the domains in each checklist. We drafted a preliminary checklist based on an aggregated list of determinants from the included checklists, and finalized the checklist by a consensus process among implementation researchers.
Results: We screened 5,778 titles and abstracts and retrieved 87 potentially relevant papers in full text. Several of these papers had references to papers that we also retrieved in full text. We also checked potentially relevant papers we had on file that were not retrieved by the searches. We included 12 checklists. None of these were completely comprehensive when compared to the aggregated list of determinants and domains. We developed a checklist with 57 potential determinants of practice grouped in seven domains: guideline factors, individual health professional factors, patient factors, professional interactions, incentives and resources, capacity for organisational change, and social, political, and legal factors. We also developed five worksheets to facilitate the use of the checklist.
Conclusions: Based on a systematic review and a consensus process we developed a checklist that aims to be comprehensive and to build on the strengths of each of the 12 included checklists. The checklist is accompanied with five worksheets to facilitate its use in implementation research and quality improvement projects.
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References
- Baker R, Camosso-Stefinovic J, Gillies C, Shaw EJ, Cheater F, Flottorp S. Tailored interventions to overcome identified barriers to change: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2010.
- Wensing M, Oxman A, Baker R, Godycki-Cwirko M, Flottorp S, Szecsenyi J. Tailored implementation for chronic diseases (TICD): A project protocol. Implement Sci. 2011;6:103. doi: 10.1186/1748-5908-6-103.
- Wensing M, Bosch M, Foy R, van der Weijden T, Eccles M, Grol R. Factors in theories on behaviour change to guide implementation and quality improvement in health care. Nijmegen: Centre for Quality of Care Research (WOK); 2005.
- Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud PA. Why don’t physicians follow clinical practice guidelines? A framework for improvement. JAMA. 1999;282:1458–1465. doi: 10.1001/jama.282.15.1458.
- Mäkelä M, Thorsen T. In: Changing professional practice. Theory and practice of clinical guidelines implementation. First. Thorsen T, Mäkelä M, editor. Copenhagen: DSI - Danish Institute for Health Services Research; 1999. A framework for guidelines implementation studies; pp. 23–53.
- Grol R, Wensing M. What drives change? Barriers to and incentives for achieving evidence-based practice. Med J Aust. 2004;180:S57–S60.
- Michie S, Johnston M, Abraham C, Lawton R, Parker D, Walker A. Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care. 2005;14:26–33. doi: 10.1136/qshc.2004.011155.
- Rainbird K, Sanson-Fisher R, Buchan H. Identifying barriers to evidence uptake. Melbourne: National Institute of Clinical Studies (NICS); 2006.
- Stavri Z, Michie S. Classification systems in behavioural science: current systems and lessons from the natural, medical and social sciences. Health Psychology Review. 2012;6:113–140. doi: 10.1080/17437199.2011.641101.
- Feinstein AR. Clinimetrics. New Haven, Conn: Yale University Press; 1987. pp. 141–166.
- Oxman AD, Guyatt GH. Validation of an index of the quality of review articles. J Clin Epidemiol. 1991;44:1271–1278. doi: 10.1016/0895-4356(91)90160-B.
- Oxman AD, Guyatt GH, Cook DJ, Jaeschke R, Heddle N, Keller J. An index of scientific quality for health reports in the lay press. J Clin Epidemiol. 1993;46:987–1001. doi: 10.1016/0895-4356(93)90166-X.
- Atkins D, Eccles M, Flottorp S, Guyatt GH, Henry D, Hill S. Systems for grading the quality of evidence and the strength of recommendations I: critical appraisal of existing approaches. The GRADE working group. BMC Health Serv Res. 2004;4:38. doi: 10.1186/1472-6963-4-38.
- Cochrane LJ, Olson CA, Murray S, Dupuis M, Tooman T, Hayes S. Gaps between knowing and doing: understanding and assessing the barriers to optimal health care. J Contin Educ Health Prof. 2007;27:94–102. doi: 10.1002/chp.106.
- Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:50. doi: 10.1186/1748-5908-4-50.
- Gurses AP, Marsteller JA, Ozok AA, Xiao Y, Owens S, Pronovost PJ. Using an interdisciplinary approach to identify factors that affect clinicians’ compliance with evidence-based guidelines. Crit Care Med. 2010;38:S282–S291.
- Greenhalgh T, Robert G, Bate P, Kyriakidou O, Macfarlane F, Peacock R. How to spread good ideas: A systematic review of the literature on diffusion, dissemination and sustainability of innovations in health service delivery and organisation. London: NCCSDO; 2004. (Report for the National Co-ordinating Centre for NHS Service Delivery and Organisation R & D (NCCSDO)).
- Kitson AL, Rycroft-Malone J, Harvey G, McCormack B, Seers K, Titchen A. Evaluating the successful implementation of evidence into practice using the PARiHS framework: theoretical and practical challenges. Implement Sci. 2008;3:1. doi: 10.1186/1748-5908-3-1.
- SURE Collaboration. SURE Guides for Preparing and Using Evidence-Based Policy Briefs: 5. Identifying and addressing barriers to implementing policy options. 2011. Version 2.0 [updated August 2011]. The SURE Collaboration.
- Saillour-Glenisson F, Michel P. Individual and collective facilitators of and barriers to the use of clinical practice guidelines by physicians: a literature review. Rev Epidemiol Sante Publique. 2003;51:65–80.
- Kitson A, Harvey G, McCormack B. Enabling the implementation of evidence based practice: a conceptual framework. Qual Health Care. 1998;7:149–158. doi: 10.1136/qshc.7.3.149.
- Bosch M, Wensing M, Eccles MP, van der Weijden T, Grol R. How to develop an effective program for improving patient care. Nijmengen: Institute for Quality of Healthcare; 2009. pp. 73–113.
- Gurses AP, Murphy DJ, Martinez EA, Berenholtz SM, Pronovost P. A practical tool to identify and eliminate barriers to compliance with evidence-based guidelines. Jt Comm J Qual Patient Saf. 2009;35:526–532.
Source: PubMed