Evidence map›Paper›PMID 37697946›Full record

ArticleHospital pediatrics2023

Barriers and Facilitators of High-Efficiency Clinical Pathway Implementation in Community Hospitals.

Simon M Outram, Sahar N Rooholamini, Mansi Desai, Yeelen Edwards, Clairissa Ja, Kayce Morton, Jordan H Vaughan, Judith S Shaw, Ralph Gonzales, Sunitha V Kaiser

Open access · bronzeAbstract read
In one paragraph

Article in Hospital pediatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.3field-weighted citation impact, top 17% of its field
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

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
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

10 authors at 5 institutions in 1 country.

Simon M Outram *Department of Pediatrics, University of California, San Francisco, California.
Sahar N Rooholamini *Department of Pediatrics, University of Washington, Seattle, Washington.
Mansi DesaiDepartment of Pediatrics, University of California, San Francisco, California.
Yeelen EdwardsDepartment of Pediatrics, University of California, San Francisco, California.
Clairissa JaUniversity of California, Davis, California.
Kayce MortonDepartment of Pediatrics, CoxHealth, Springfield, Missouri.
Jordan H VaughanDepartment of Pediatrics, University of California, San Francisco, California.
Judith S ShawDepartment of Pediatrics, University of Vermont, Burlington, Vermont.
Ralph GonzalesDepartment of Pediatrics, University of California, San Francisco, California.
Sunitha V KaiserDepartment of Pediatrics, University of California, San Francisco, California.
University of California, San Francisco · USCoxHealth · USUniversity of California, Davis · USUniversity of Vermont · USUniversity of Washington · US

Funding

The SIP Study: Simultaneously Implementing Pathways for Improving Asthma, Pneumonia, and Bronchiolitis Care for Hospitalized ChildrenR33HL157804 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KAISER, SUNITHA VEMULA · 2022 to 2025
$2.3M
The SIP Study: Simultaneously Implementing Pathways for Improving Asthma, Pneumonia, and Bronchiolitis Care for Hospitalized ChildrenR61HL157804 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KAISER, SUNITHA VEMULA · 2021 to 2021
$707k
NHLBI NIH HHS R33 HL157804NHLBI NIH HHS R61 HL157804
6 · The paper itself

Abstract

backgroundAn intervention that involved simultaneously implementing clinical pathways for multiple conditions was tested at a tertiary children's hospital and it improved care quality. We are conducting a randomized trial to evaluate this multicondition pathway intervention in community hospitals. Our objectives in this qualitative study were to prospectively (1) identify implementation barriers and (2) map barriers to facilitators using an established implementation science framework.

methodsWe recruited participants via site leaders from hospitals enrolled in the trial. We designed an interview guide using the Consolidated Framework for Implementation Research and conducted individual interviews. Analysis was done using constant comparative methods. Anticipated barriers were mapped to facilitators using the Capability, Opportunity, Motivation, Behavior Framework.

resultsParticipants from 12 hospitals across the United States were interviewed (n = 21). Major themes regarding the multicondition pathway intervention included clinician perceptions, potential benefits, anticipated barriers/challenges, potential facilitators, and necessary resources. We mapped barriers to additional facilitators using the Capability, Opportunity, Motivation, Behavior framework. To address limited time/bandwidth of clinicians, we will provide Maintenance of Certification credits. To address new staff and trainee turnover, we will provide easily accessible educational videos/resources. To address difficulties in changing practice across other hospital units, we will encourage emergency department engagement. To address parental concerns with deimplementation, we will provide guidance on parent counseling.

conclusionsWe identified several potential barriers and facilitators for implementation of a multicondition clinical pathway intervention in community hospitals. We also illustrate a prospective process for identifying implementation facilitators.

Indexed as

Critical PathwaysHospitals, CommunityEfficiency, OrganizationalHospitals, PediatricHumansQualitative ResearchQuality ImprovementUnited States

Identifiers

PMID37697946
PMCPMC10520265
OpenAlexW4386624678

What OpenQuestion holds

Textmetadata
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.