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Am J Perinatol 2021; 38(07): 643-648
DOI: 10.1055/s-0040-1721728
DOI: 10.1055/s-0040-1721728
SMFM Fellowship Series Article
Implementation Science is Imperative to the Optimization of Obstetric Care
Funding The study received its financial support from T32 Training Grant in Reproductive Epidemiology (T32-HD007440).
Abstract
In an effort aimed at improving outcomes, obstetric teams have enacted comprehensive care bundles and other clinical tools. Yet, these practices have had limited degrees of success on a national scale. Implementation science aims to bridge the divide between the development of evidence-based interventions and their real-world utilization. This emerging field takes into account key stakeholders at the clinician, institution, and health policy levels. Implementation science evaluates how well an intervention is or can be delivered, to whom, in which context, and how it may be up-scaled and sustained. Other medical disciplines have embraced these concepts with success. The frameworks and theories of implementation science can and should be incorporated into both obstetric research and practice. By doing so, we can increase widespread and timely adoption of evidence and further our common goal of decreasing maternal morbidity and mortality.
Key Points
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Evidence-based practices have been implemented in obstetrics with variable success.
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Implementation science aims to bridge the divide between the development of evidence-based interventions and their real-world utilization.
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The methodologies of implementation science may be helpful to obstetric research and practice.
Publication History
Received: 02 September 2020
Accepted: 04 November 2020
Article published online:
15 December 2020
© 2020. Thieme. All rights reserved.
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References
- 1
World Health Organization,
Trends in maternal mortality 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World
Bank Group and the United Nations Population Division: executive summary.
2019 . Accessed 2019 at: https://apps.who.int/iris/handle/10665/327596
MissingFormLabel
- 2
Martin JA,
Hamilton BE,
Osterman MJ,
Curtin SC,
Matthews TJ.
Births: final data for 2013. Natl Vital Stat Rep 2015; 64 (01) 1-65
MissingFormLabel
- 3 Creanga AA, Bateman BT, Kuklina EV, Callaghan WM. Racial and ethnic disparities in severe maternal morbidity: a multistate analysis, 2008-2010. Am J Obstet Gynecol 2014; 210 (05) 435.e1-435.e8
- 4 Hirshberg A, Srinivas SK. Epidemiology of maternal morbidity and mortality. Semin Perinatol 2017; 41 (06) 332-337
- 5 ACOG Committee Opinion No. ACOG committee opinion no. 649: racial and ethnic disparities in obstetrics and gynecology. Obstet Gynecol 2015; 126 (06) e130-e134
- 6 Blumenshine P, Egerter S, Barclay CJ, Cubbin C, Braveman PA. Socioeconomic disparities in adverse birth outcomes: a systematic review. Am J Prev Med 2010; 39 (03) 263-272
- 7 Moaddab A, Dildy GA, Brown HL. et al. Health care disparity and pregnancy-related mortality in the United States, 2005-2014. Obstet Gynecol 2018; 131 (04) 707-712
- 8 Main EK, Goffman D, Scavone BM. et al; National Partnership for Maternal Safety, Council on Patient Safety in Women's Health Care. National partnership for maternal safety: consensus bundle on obstetric hemorrhage. Obstet Gynecol 2015; 126 (01) 155-162
- 9 DʼAlton ME, Friedman AM, Smiley RM. et al. National partnership for maternal safety: consensus bundle on venous thromboembolism. Obstet Gynecol 2016; 128 (04) 688-698
- 10 Howell EA, Brown H, Brumley J. et al. Reduction of peripartum racial and ethnic disparities: a conceptual framework and maternal safety consensus bundle. Obstet Gynecol 2018; 131 (05) 770-782
- 11 Balas EA, Boren SA. Managing clinical knowledge for health care improvement. In: Bemmel J, McCray AT. eds. Yearbook of Medical Informatics 2000: Patient-Centered Systems. Stuttgart, Germany: Schattauer Verlagsgesellschaft mbH; 2000: 65-70
- 12 Green LW, Ottoson JM, García C, Hiatt RA. Diffusion theory and knowledge dissemination, utilization, and integration in public health. Annu Rev Public Health 2009; 30: 151-174
- 13 Morris ZS, Wooding S, Grant J. The answer is 17 years, what is the question: understanding time lags in translational research. J R Soc Med 2011; 104 (12) 510-520
- 14 Liggins GC, Howie RN. A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants. Pediatrics 1972; 50 (04) 515-525
- 15 Roberts D, Brown J, Medley N, Dalziel SR. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev 2017; 3: CD004454
- 16 Razaz N, Skoll A, Fahey J, Allen VM, Joseph KS. Trends in optimal, suboptimal, and questionably appropriate receipt of antenatal corticosteroid prophylaxis. Obstet Gynecol 2015; 125 (02) 288-296
- 17 Levin HI, Ananth CV, Benjamin-Boamah C, Siddiq Z, Son M, Friedman AM. Clinical indication and timing of antenatal corticosteroid administration at a single centre. BJOG 2016; 123 (03) 409-414
- 18 Makhija NK, Tronnes AA, Dunlap BS, Schulkin J, Lannon SM. Antenatal corticosteroid timing: accuracy after the introduction of a rescue course protocol. Am J Obstet Gynecol 2016; 214 (01) 120.e1-120.e6
- 19 Adams TM, Kinzler WL, Chavez MR, Fazzari MJ, Vintzileos AM. Practice patterns in the timing of antenatal corticosteroids for fetal lung maturity. J Matern Fetal Neonatal Med 2015; 28 (13) 1598-1601
- 20 ACOG Practice Bulletin No. ACOG practice bulletin no. 190 summary: gestational diabetes mellitus. Obstet Gynecol 2018; 131 (02) 406-408
- 21 Almario CV, Ecker T, Moroz LA, Bucovetsky L, Berghella V, Baxter JK. Obstetricians seldom provide postpartum diabetes screening for women with gestational diabetes. Am J Obstet Gynecol 2008; 198 (05) 528.e1-528.e5
- 22 Smirnakis KV, Chasan-Taber L, Wolf M, Markenson G, Ecker JL, Thadhani R. Postpartum diabetes screening in women with a history of gestational diabetes. Obstet Gynecol 2005; 106 (06) 1297-1303
- 23 Bauer MS, Damschroder L, Hagedorn H, Smith J, Kilbourne AM. An introduction to implementation science for the non-specialist. BMC Psychol 2015; 3: 32
- 24 Nilsen P. Making sense of implementation theories, models and frameworks. Implement Sci 2015; 10: 53
- 25 Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health 1999; 89 (09) 1322-1327
- 26 Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci 2009; 4: 50
- 27 Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci 2011; 6: 42
- 28 Powell BJ, McMillen JC, Proctor EK. et al. A compilation of strategies for implementing clinical innovations in health and mental health. Med Care Res Rev 2012; 69 (02) 123-157
- 29 Powell BJ, Beidas RS, Lewis CC. et al. Methods to improve the selection and tailoring of implementation strategies. J Behav Health Serv Res 2017; 44 (02) 177-194
- 30 Lewis CC, Fischer S, Weiner BJ, Stanick C, Kim M, Martinez RG. Outcomes for implementation science: an enhanced systematic review of instruments using evidence-based rating criteria. Implement Sci 2015; 10: 155
- 31 Proctor E, Silmere H, Raghavan R. et al. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health 2011; 38 (02) 65-76
- 32 Curran GM, Bauer M, Mittman B, Pyne JM, Stetler C. Effectiveness-implementation hybrid designs: combining elements of clinical effectiveness and implementation research to enhance public health impact. Med Care 2012; 50 (03) 217-226
- 33 Pallmann P, Bedding AW, Choodari-Oskooei B. et al. Adaptive designs in clinical trials: why use them, and how to run and report them. BMC Med 2018; 16 (01) 29
- 34
Hemming K,
Eldridge S,
Forbes G,
Weijer C,
Taljaard M.
How to design efficient cluster randomised trials. BMJ 2017; 358: j3064
MissingFormLabel
- 35 Handley MA, Lyles CR, McCulloch C, Cattamanchi A. Selecting and improving quasi-experimental designs in effectiveness and implementation research. Annu Rev Public Health 2018; 39: 5-25
- 36 Weisz JR, Southam-Gerow MA, Gordis EB. et al. Cognitive-behavioral therapy versus usual clinical care for youth depression: an initial test of transportability to community clinics and clinicians. J Consult Clin Psychol 2009; 77 (03) 383-396
- 37 Jones C, Hacker D, Xia J. et al. Cognitive behavioural therapy plus standard care versus standard care for people with schizophrenia. Cochrane Database Syst Rev 2018; 12: CD007964
- 38
Lopez PL,
Torrente FM,
Ciapponi A.
et al.
Cognitive-behavioural interventions for attention deficit hyperactivity disorder (ADHD)
in adults. Cochrane Database Syst Rev 2018; 3: CD010840
MissingFormLabel
- 39 Kataoka SH, Zhang L, Wells KB. Unmet need for mental health care among U.S. children: variation by ethnicity and insurance status. Am J Psychiatry 2002; 159 (09) 1548-1555
- 40 Kramer TL, Burns BJ. Implementing cognitive behavioral therapy in the real world: a case study of two mental health centers. Implement Sci 2008; 3 (14) 14
- 41 Lewis CC, Simons AD. A pilot study disseminating cognitive behavioral therapy for depression: therapist factors and perceptions of barriers to implementation. Adm Policy Ment Health 2011; 38 (04) 324-334
- 42 Cucciare MA, Curran GM, Craske MG. et al. Assessing fidelity of cognitive behavioral therapy in rural VA clinics: design of a randomized implementation effectiveness (hybrid type III) trial. Implement Sci 2016; 11 (01) 65
- 43 Mignogna J, Martin LA, Harik J. et al. “I had to somehow still be flexible”: exploring adaptations during implementation of brief cognitive behavioral therapy in primary care. Implement Sci 2018; 13 (01) 76
- 44 Kauth MR, Sullivan G, Blevins D. et al. Employing external facilitation to implement cognitive behavioral therapy in VA clinics: a pilot study. Implement Sci 2010; 5 (01) 75
- 45
QualRIS (Qualitative Research in Implementation Science) Group,
Qualitative Methods in Implementation Science,
National Cancer Institute.
2018 . Accessed 2020 at: https://cancercontrol.cancer.gov/IS/docs/NCI-DCCPS-ImplementationScience-WhitePaper.pdf
MissingFormLabel
- 46 Hamilton AB, Finley EP. Qualitative methods in implementation research: an introduction. Psychiatry Res 2019; 280: 112516
- 47 Nápoles AM, Stewart AL. Transcreation: an implementation science framework for community-engaged behavioral interventions to reduce health disparities. BMC Health Serv Res 2018; 18 (01) 710
- 48 Niven DJ, Mrklas KJ, Holodinsky JK. et al. Towards understanding the de-adoption of low-value clinical practices: a scoping review. BMC Med 2015; 13: 255
- 49 Ovretveit J, Mittman B, Rubenstein L, Ganz DA. Using implementation tools to design and conduct quality improvement projects for faster and more effective improvement. Int J Health Care Qual Assur 2017; 30 (08) 755-768
- 50 Hamm RF, Wang E, O'Rourke K, Romanos A, Srinivas SK. Institution of a comprehensive postpartum hemorrhage bundle at a large academic center does not immediately reduce maternal morbidity. Am J Perinatol 2019; 36 (01) 15-21
- 51 Hamm RF, Wang E, Romanos A, O'Rourke K, Srinivas SK. Implementation of quantification of blood loss does not improve prediction of hemoglobin drop in deliveries with average blood loss. Am J Perinatol 2018; 35 (02) 134-139
- 52 Main EK, Chang SC, Dhurjati R, Cape V, Profit J, Gould JB. Reduction in racial disparities in severe maternal morbidity from hemorrhage in a large-scale quality improvement collaborative. Am J Obstet Gynecol 2020; 223 (01) 123.e1-123.e14 ; Epub ahead of print
- 53 Harper KD, Loper AC, Louison LM, Morse JE. Stage-based implementation of immediate postpartum long-acting reversible contraception using a reproductive justice framework. Am J Obstet Gynecol 2020; 222 (4S): S893-S905
- 54 American College of Obstetricians and Gynecologists' Committee on Obstetric Practice. Committee opinion no. 670: immediate postpartum long-acting reversible contraception. Obstet Gynecol 2016; 128 (02) e32-e37
- 55 Warren CE, Ndwiga C, Sripad P. et al. Sowing the seeds of transformative practice to actualize women's rights to respectful maternity care: reflections from Kenya using the consolidated framework for implementation research. BMC Womens Health 2017; 17 (01) 69
- 56 Rosenstein MG. Application of implementation science to OB/GYN quality improvement efforts. Clin Obstet Gynecol 2019; 62 (03) 594-605