6th UK and Ireland Implementation Science Research Conference 2023
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Biography
Dr. Rachel Flynn’s research program – Sustaining Innovations in Child Health (STITCH) aims to improve the health outcomes of children through implementing and sustaining effective evidence- based innovations across various child health contexts. Dr. Flynn offers expertise in implementation science, innovation sustainability, realist methods, qualitative research, and knowledge synthesis approaches.
She completed a PhD (2018) in Nursing at the University of Alberta, Canada and a Post-Doctoral Fellowship (2021) at the Hospital for Sick Kids, Toronto and the University of Alberta. She is currently a Lecturer at the School of Nursing and Midwifery, University College Cork. She was previously an Assistant Professor (2021) at the University of Alberta, where she spent 10 years in child health services research in Canada.
background
This scoping review aimed to consolidate the current evidence on: i) what and how KT strategies are being used for the sustainability of evidence-based interventions (EBIs) in institutional healthcare settings; ii) barriers and facilitators to the use of KT strategies for sustainability; and iii) reported KT implementation outcomes and EBI sustainability outcomes.
MEthod
We conducted a scoping review of five electronic databases. We included studies that described the use of specific KT strategies to facilitate the sustainability of EBIs (more than 1 year post-implementation). Two reviewers independently screened titles and abstracts, full text papers, and extracted data. We coded KT strategies using the ERIC taxonomy of implementation strategies and barriers/facilitators using the Consolidated Framework for Sustainability. We performed descriptive numerical summaries and a narrative synthesis to analyze results.
results
From the 25 included studies, the most common KT strategies for sustainability of an EBI were train & educate stakeholders (n=38) and develop stakeholder interrelationships (n=34). Barriers to KT strategy use for EBI sustainability were mostly related to resources (n=20). Facilitators to KT strategy use for EBI sustainability were mostly related to the people involved (n=28) and design and delivery of the KT strategy (n=20). Most studies (n=11) did not clearly report whether they used different or the same KT strategies between EBI implementation and EBI sustainability. Seven studies adapted their KT strategies from implementation to sustainability and only two studies reported using a new KT strategy for EBI sustainability.
Conclusion
Our review provides insight into a conceptual problem where implementation and sustainability are two discrete activities that occur at separate times. Our findings show we need to consider implementation and sustainability as a continuum and at the start of the EBI implementation select, design and adapt KT strategies across the continuum with this in mind.