ArticleBMC health services research2018
Using normalisation process theory to evaluate the implementation of a complex intervention to embed the surgical safety checklist.
Article in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Teamwork and implementation of innovations in healthcare and human service settings: a systematic review.Implementation science : IS · 2024Pooled it
- Trial
- Trial
- The implementation and validation of the NoMAD during a complex primary care intervention.BMC medical research methodology · 2022Trial
- Does the Surgical Safety Checklist need a co-pilot? Comparing adherence in gynecological surgery through electronic medical records and OR Black Box video observations.Surgical endoscopy · 2025Observational
- Interventions to Improve Compliance to Surgical Safety Checklist Use: Before-and-After Study at a Tertiary Public Hospital in Croatia.Healthcare (Basel, Switzerland) · 2025Article
- Translational framework for implementation evaluation and research: implementation strategies derived from normalization process theory.Implementation science : IS · 2025Article
- Psychometric evaluation of the NoMAD instrument in cancer care settings: assessing factorial validity, measurement invariance, and differential item functioning.Implementation science communications · 2025Article
- Developing Implementation Strategies for the Adoption of the Enhanced Recovery After Surgery (ERAS) Protocols: A Co-Design Study.Health expectations : an international journal of public participation in health care and health policy · 2025Article
- Applying Normalisation Process Theory to a peer-delivered complex health intervention for people experiencing homelessness and problem substance use.Communications medicine · 2025Article
- Exploring the Normalisation of Telepsychiatry Practice Among Private Psychiatrists in Australia: A Convergent Mixed Methods Study.International journal of telemedicine and applications · 2025Article
- Implementation and impact of NHS-funded tobacco dependence services in England: a mixed-method evaluation protocol.BMJ open · 2024Article
- Therapist perceptions of the implementation of a new screening procedure using the ItFits-toolkit in an iCBT routine care clinic: A mixed-methods study using the consolidated framework for implementation research.Frontiers in psychiatry · 2023Article
- Pilot of a person-centred, interdisciplinary approach to goal setting in Ireland's National Rehabilitation Hospital: a study protocol.HRB open research · 2023Article
- State-wide implementation of patient-reported outcome measures (PROMs) in specialized outpatient palliative care teams (ELSAH): A mixed-methods evaluation and implications for their sustainable use.BMC palliative care · 2022Article
- Validity and reliability of the Chinese version of the Normalization MeAsure Development(NoMAD).BMC health services research · 2022Article
- Governance factors that affect the implementation of health financing reforms in Tanzania: an exploratory study of stakeholders' perspectives.BMJ global health · 2021Article
- Article
- Implementation of a first-trimester prognostic model to improve screening for gestational diabetes mellitus.BMC pregnancy and childbirth · 2021Article
- Safe surgery checklist: evaluation in a neotropical region.Revista do Colegio Brasileiro de Cirurgioes · 2021Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundThe surgical Safety Checklist (SSC) was introduced in 2008 to improve teamwork and reduce the mortality and morbidity associated with surgery. Although mandated in many health care institutions around the world, challenges in implementation of the SSC continue. To use Normalisation Process Theory (NPT) to help understand how/why implementation of a complex intervention coined Pass The Baton (PTB) could help explain what facets of the Surgical Safety Checklist use led to its' integration in practice, while others were not.
methodsA longitudinal multi-method study using survey and interviews was undertaken. Implementation of PTB involved; change champions, audit and feedback, education and prompts. Following implementation, surgical teams were surveyed using the NOrmalization MeAsure Development (NoMAD) and subsequently interviewed to explore the impact of PTB on their use of the checklist at 6 and 12 months respectively. Respondents' self-reported perceptions of implementation of PTB was explained using the four NPT constructs; coherence, cognitive participation, collective action, and reflexive monitoring. Survey data were analysed using descriptive statistics. Interview data were coded inductively and content analysed using a framework derived from NPT.
resultsThe NoMAD survey response rate was 59/150 (39.3%). Many (45/59, 77.6%) survey respondents saw the value in PTB, while 50/59 (86.2%) would continue to use it; 45/59 (77.6%) believed that PTB could easily be integrated into existing workflows, and 48/59 (82.8%) thought that feedback could improve PTB in the future. A total of 8 interviews were completed with 26 surgical team members. Nurses and physicians held mixed views towards coherence while buy-in and participation relied on individuals' investment in the implementation process and the ability to modify PTB. Participants generally recognised the benefit and value of using PTB in the ongoing implementation the checklist.
conclusionsWorkarounds and flexible co-construction in implementation designed to improve team communications in surgery may facilitate their normalisation in practice.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.