Evidence map›Paper›PMID 29796266›Full record

ReviewSAGE open medicine2018

Inside help: An integrative review of champions in healthcare-related implementation.

Edward J Miech, Nicholas A Rattray, Mindy E Flanagan, Laura Damschroder, Arlene A Schmid, Teresa M Damush

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in SAGE open medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 252 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
252citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

252 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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  8. Using After Action Review to Identify Rapid Response Implementation Strategies for Emerging Drugs Among Youth.Prevention science : the official journal of the Society for Prevention Research · 2025
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192 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Edward J MiechVA Precision Monitoring (PRIS-M) QUERI, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA.ORCID https://orcid.org/0000-0002-7187-1570
Nicholas A RattrayVA Precision Monitoring (PRIS-M) QUERI, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA.
Mindy E FlanaganVA Precision Monitoring (PRIS-M) QUERI, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA.
Laura DamschroderVA Health Services Research & Development Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
Arlene A SchmidDepartment of Occupational Therapy, Colorado State University, College of Health and Human Sciences, Fort Collins, CO, USA.
Teresa M DamushVA Precision Monitoring (PRIS-M) QUERI, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

aimsThe idea that champions are crucial to effective healthcare-related implementation has gained broad acceptance; yet the champion construct has been hampered by inconsistent use across the published literature. This integrative review sought to establish the current state of the literature on champions in healthcare settings and bring greater clarity to this important construct.

methodsThis integrative review was limited to research articles in peer-reviewed, English-language journals published from 1980 to 2016. Searches were conducted on the online MEDLINE database via OVID and PubMed using the keyword "champion." Several additional terms often describe champions and were also included as keywords: implementation leader, opinion leader, facilitator, and change agent. Bibliographies of full-text articles that met inclusion criteria were reviewed for additional references not yet identified via the main strategy of conducting keyword searches in MEDLINE. A five-member team abstracted all full-text articles meeting inclusion criteria.

resultsThe final dataset for the integrative review consisted of 199 unique articles. Use of the term champion varied widely across the articles with respect to topic, specific job positions, or broader organizational roles. The most common method for operationalizing champion for purposes of analysis was the use of a dichotomous variable designating champion presence or absence. Four studies randomly allocated of the presence or absence of champions.

conclusionsThe number of published champion-related articles has markedly increased: more articles were published during the last two years of this review (i.e. 2015-2016) than during its first 30 years (i.e. 1980-2009).The number of champion-related articles has continued to increase sharply since the year 2000. Individual studies consistently found that champions were important positive influences on implementation effectiveness. Although few in number, the randomized trials of champions that have been conducted demonstrate the feasibility of using experimental design to study the effects of champions in healthcare.

Indexed as

championsimplementation researchintegrative reviewNursing

Identifiers

PMID29796266
PMCPMC5960847

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.