Table 1 The 19 healthcare professional level implementation strategies in the Effective Practice and Organization of Care (EPOC) Taxonomy [22]
Implementation strategy group for the purpose of this review | EPOC implementation strategies (N = 19) | Definition | Example |
|---|---|---|---|
Group 1: Individual clinician education | Clinical practice guidelines | Dissemination of systematically developed guidelines intended to assist healthcare professionals and patients in making informed decisions about appropriate healthcare for specific clinical conditions | Providing nurses in geriatric care with updated guidelines on fall prevention strategies |
Educational materials | Development and distribution of manuals, toolkits, and other resources either in-person, in print, or online, designed to facilitate healthcare professionals' understanding and delivery of clinical innovations | Distributing a handbook to oncology nurses on the latest chemotherapy administration protocols | |
Educational games | Utilization of interactive games either in-person, in print, or online as a method to enhance learning and improve standards of care among healthcare professionals | A mobile app game designed for nurses to practice emergency response scenarios, enhancing their decision-making skills in critical situations | |
Educational outreach visits, or academic detailing | Personalized education sessions conducted by trained individuals who visit healthcare professionals in their practice settings to inform and influence practice patterns towards the adoption of clinical innovations | Academic detailers visiting community health centers to train nurses on the use of new digital tools for patient management | |
Group 2: Group clinician education | Educational meetings | Organization of events such as workshops, courses, or conferences specifically targeted at healthcare professionals to educate and train them about new clinical practices or innovations | A workshop for nurse practitioners on advanced wound care techniques, including the use of new biologic dressings |
Communities of practice | Formation of groups comprising individuals with shared interests who engage regularly to enhance their knowledge and expertise through collaborative learning | A virtual community of practice for pediatric nurses to discuss challenges and solutions in neonatal care | |
Interprofessional education | Continuing education programs for healthcare professionals from various disciplines, aimed at fostering a collaborative environment to enhance the implementation of clinical innovations | An interprofessional training session for nurses, physicians, and pharmacists on multidisciplinary approaches to pain management | |
Group 3: Clinician reminders | Reminders | Manual or computerized prompts that direct healthcare professionals to perform specific actions during interactions with patients, such as those provided by computerized decision support systems | Computer alerts reminding nurses in the intensive care unit to assess patients for delirium at specific intervals |
Group 4: Patient-mediated interventions | Patient-mediated Interventions | Strategies aimed at modifying healthcare professional behavior through direct engagement with patients, equipping patients to be proactive about their care and to question their healthcare guidelines and treatments | Educating patients in a diabetes clinic on how to communicate effectively with their nurses about their insulin usage and concerns |
Group 5: Public release of performance data | Public release of performance data | Making performance data for healthcare professionals available to the public through written or electronic reports, intended to inform and influence consumer choice and provider accountability | Publishing annual nursing care quality metrics for a maternity ward on the hospital website to help expectant mothers choose their care providers |
Group 6: Managerial supervision | Managerial supervision | Provision of continuous oversight and training for clinical supervisors who are tasked with overseeing the delivery of clinical innovations by healthcare providers | Implementing a mentoring program where experienced nurse supervisors provide guidance and feedback to newly graduated nurses during their first year of practice |
Group 7: Audit and feedback | Audit and feedback | Regular summaries of healthcare professionals’ performance, provided in written, electronic, or verbal format, often accompanied by recommendations for clinical improvements | Feedback sessions where nurse managers review monthly infection control practices with their team and suggest improvements |
Monitoring the performance of the delivery of healthcare | Ongoing assessment of healthcare services by individuals or organizations, comparing them against external standards to ensure quality and compliance | Regular audits of nursing documentation in the electronic health record to ensure accuracy and completeness of patient care information | |
Routine patient-reported outcome measures | Systematic collection and analysis of data reported directly by patients about their health outcomes, used to inform healthcare delivery and patient care strategies | Nurses collecting and reviewing patient feedback on post-operative care in a surgical unit to improve nursing protocols | |
Continuous quality improvement | An iterative method involving healthcare teams to continuously review and enhance the quality of care, incorporating systematic problem-solving methods and data analysis | A nurse-led initiative to reduce patient wait times in the emergency department by analyzing triage procedures and implementing efficiency improvements | |
Clinical incident reporting | Systems designed to document and report critical incidents in healthcare settings, aimed at identifying and mitigating risks to patient safety | A system where nurses can report any medication errors or near misses, which is then reviewed for process improvement | |
Group 8: Tailored interventions | Tailored interventions | Customized strategies designed to address specific barriers or to leverage facilitators identified through assessments such as surveys or interviews, intended to enhance the adoption of clinical practices | Developing a tailored implementation strategy for nurses in a neonatal intensive care unit (NICU) based on a survey that identified specific barriers in adopting a new protocol for managing neonatal abstinence syndrome |
Local consensus processes | Engagement of local healthcare professionals and stakeholders in discussions to evaluate the relevance and appropriateness of a clinical innovation, through formal or informal consensus-building methods | Facilitating discussions among nursing teams to decide on the adoption of a new patient safety checklist | |
Group 9: Local opinion leaders | Local opinion leaders | Identification and informational engagement of key influencers within the healthcare community, recognized by their peers as leaders, to promote the adoption of clinical innovations among their colleagues | Engaging a highly respected nurse to promote best practices in patient-centered care across nursing teams |