![]() ![]() Additionally, toolkits often include resources to provide education, and tools to assess implementation fidelity and implementation outcomes are less-commonly included. Although toolkits are associated with improved clinical outcomes, the content of toolkits often focus on the steps required to complete the clinical intervention with less emphasis on the strategies used to facilitate implementation in real-world settings. Toolkits to support the implementation of evidence-based interventions commonly target healthcare providers, although toolkits may also inform community partners, patients, and other stakeholders. Development of a toolkit from start to finish is a multi-step process, and methods for toolkit development may include interviewing healthcare providers, conducting observations or site visits, and using a Delphi approach. The use of a toolkit to support the implementation of a clinical intervention is associated with improved patient outcomes, including reduced falls, reduced number of hyperglycemic events, and reduced length of stay. Additionally, these tools may be used throughout the implementation process to support adoption (the decision to use the intervention), implementation (incorporation of the intervention into practice), and sustainment (continued use of the intervention). Toolkits may include documents which may be used individually or collectively, such as educational material, timelines, agenda templates, and assessment tools, and the tools may often be customized based on context, thus helping to bridge the translation gap between evidence and practice. A collection of tools, or a toolkit, may include adaptable resources that expedite the translation of evidence into practice with a specific focus on a single intervention or audience. ![]() For example, a “Capacity Assessment Tool” may provide a framework by which leaders assess readiness for implementation. Healthcare providers and leaders may develop tools (i.e., documents that provide information or guidance) that align with strategies used to support implementation. To address this gap between evidence and practice, Powell and colleagues have identified several strategies to support the implementation of evidence-based interventions, including identification of champions, assessment for adoption readiness, identification of barriers, and promotion of the adaptability of the intervention. This gap between evidence and practice is potentially detrimental and may result in preventable morbidity and mortality for healthcare recipients. Healthcare providers have favorable attitudes about evidence-based practice however, their intention to adopt an intervention does not consistently translate to the actual implementation of the intervention. Despite these positive outcomes, healthcare providers report evidence-based interventions are ineffectively implemented in real-world settings. The approach used to develop this implementation toolkit may be used to create resources for the implementation of other evidence-based interventions.Įvidence-based clinical interventions in healthcare are associated with increased quality of care, improved patient outcomes, and reduced healthcare costs. Each tool corresponds to one or more implementation strategies. The final toolkit included 54 different tools selected or created to define the intervention, engage and communicate with stakeholders, assess for readiness and plan for implementation, train clinical nurses and other stakeholders, evaluate training and implementation effectiveness, create policies and procedures for different contexts, and identify opportunities for reimbursement. ![]() Investigators and site coordinators from 14 acute care hospitals developed tools and engaged external stakeholders as they prepared for implementation, integrated the clinical intervention into practice, and reflected on implementation. MethodsĪ descriptive case study describes the development and use of a toolkit throughout a two-year study. This paper describes the development and use of a toolkit to guide the implementation of an evidence-based intervention to identify and intervene for people with risky substance use. Most available toolkits provide resources about the intervention but lack guidance for adaptation to different contexts or strategies to support implementation. A toolkit, or a collection of adaptable documents to inform and facilitate implementation, can increase the use of evidence-based interventions. Implementation of evidence-based clinical interventions in real-world settings becomes a futile effort when effective strategies to foster adoption are not used. ![]()
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