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Cited by 433Health Policy Implementation ScienceHealth Sciences Research and EducationClinical practice guidelines implementation

Organizational contextual features that influence the implementation of evidence-based practices across healthcare settings: a systematic integrative review

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Li, Shelly-Anne, Jeffs, Lianne, Barwick, Melanie, Stevens, Bonnie·2018·Systematic Reviews
DOI 10.1186/s13643-018-0734-5PMC PMC5936626
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Abstract

BACKGROUND: Organizational contextual features have been recognized as important determinants for implementing evidence-based practices across healthcare settings for over a decade. However, implementation scientists have not reached consensus on which features are most important for implementing evidence-based practices. The aims of this review were to identify the most commonly reported organizational contextual features that influence the implementation of evidence-based practices across healthcare settings, and to describe how these features affect implementation. METHODS: An integrative review was undertaken following literature searches in CINAHL, MEDLINE, PsycINFO, EMBASE, Web of Science, and Cochrane databases from January 2005 to June 2017. English language, peer-reviewed empirical studies exploring organizational context in at least one implementation initiative within a healthcare setting were included. Quality appraisal of the included studies was performed using the Mixed Methods Appraisal Tool. Inductive content analysis informed data extraction and reduction. RESULTS: The search generated 5152 citations. After removing duplicates and applying eligibility criteria, 36 journal articles were included. The majority (n = 20) of the study designs were qualitative, 11 were quantitative, and 5 used a mixed methods approach. Six main organizational contextual features (organizational culture; leadership; networks and communication; resources; evaluation, monitoring and feedback; and champions) were most commonly reported to influence implementation outcomes in the selected studies across a wide range of healthcare settings. CONCLUSIONS: We identified six organizational contextual features that appear to be interrelated and work synergistically to influence the implementation of evidence-based practices within an organization. Organizational contextual features did not influence implementation efforts independently from other features. Rather, features were interrelated and often influenced each other in complex, dynamic ways to effect change. These features corresponded to the constructs in the Consolidated Framework for Implementation Research (CFIR), which supports the use of CFIR as a guiding framework for studies that explore the relationship between organizational context and implementation. Organizational culture was most commonly reported to affect implementation. Leadership exerted influence on the five other features, indicating it may be a moderator or mediator that enhances or impedes the implementation of evidence-based practices. Future research should focus on how organizational features interact to influence implementation effectiveness.

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  • Organizational leadership is a critical determinant of the successful implementation of universal prevention programs in schools.

    “Organizational leadership is a critical determinant of the successful implementation of these programs.”

    From Leading the charge in the education sector: development and validation of the School Implementation Leadership Scale (SILS) (2022) · cites this paper as [2]

    The Results > Leadership section reports that leadership was an important feature for implementation effectiveness in 20 of 36 studies, and the Discussion calls leaders critical to the implementation process (page numbers unavailable). The review concerns evidence-based practices in healthcare settings; it does not establish the claim specifically for universal prevention programs in schools. (LLM, conf=0.88)

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Cited by

Sorted by citations

Authors
Li, S.-A., Jeffs, L., Barwick, M., & Stevens, B.
Affiliations
  • University of Toronto (CA)
  • St. Michael's Hospital (CA)
Corresponding author
Li, Shelly-Anne
ORCID
Venue
Systematic Reviews
Publisher
Springer Science and Business Media LLC
Published
2018-05-05
Volume
7
Issue
1
Pages
72-72
ISSN
2046-4053 (ISSN-L)
DOI
10.1186/s13643-018-0734-5
PMC
PMC5936626
OpenAlex
W2800035960
Cited by
433
References
13
Citations by year
2026: 33 · 2025: 63 · 2024: 95 · 2023: 56 · 2022: 68 · 2021: 61 · 2020: 32 · 2019: 20 · 2018: 4
FWCI
5.33
Type
journal article
Language
en
Open access
Licence
Locations
  • Systematic Reviews (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • TSpace (University of Toronto) (acceptedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Canadian Institutes of Health Research (148452)
  • Pain in Child Health (53885)
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
Keywords
organizational context, evidence-based practice implementation, healthcare organizations, organizational culture, leadership, organizational resources, monitoring and evaluation, champions, Consolidated Framework for Implementation Research, implementation outcomes
MeSH terms
Delivery of Health Care, Health Plan Implementation, Humans, Leadership, Organizational Culture, Evidence-Based Practice, Translational Research, Biomedical

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