Barriers to improvement in the NHS

"Every day, teams within the NHS strive to make things better, but individual, organisational and system-wide barriers get in the way. This evidence scan compiles published research about the key barriers to improvement in the NHS."

What's getting in the way?: Barriers to improvement in the NHS
D de Silva
The Health Foundation
February 2015

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Facilitators and barriers to applying a national quality registry for quality improvement in stroke care

"the quality improvement process needs to be facilitated by stakeholders collaborating within and outside the context, who know how to initiate, perform, and evaluate quality improvement, and who have the resources to do so."

Facilitators and barriers to applying a national quality registry for quality improvement in stroke care
AC Eldh, M Fredriksson, C Halford, L Wallin, T Dahlström, S Vengberg, U Winblad
BMC Health Services Research 2014, 14:354

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Barriers to implementation of a redesign of information transfer and feedback in acute care

"Accurate communication is an important feature of seamless care and enhances patient safety. Information transfer and patient handovers are noted to be potentially hazardous areas for error in emergency care."

Barriers to implementation of a redesign of information transfer and feedback in acute care: results from a multiple case study
JE van Leijen-Zeelenberg, AJA van Raak, IGP Duimel-Peeters, MEAL Kroese, PRG Brink, D Ruwaard, HJM Vrijhoef
BMC Health Services Research, 2014, 14: 149

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Preferences of users of electronic medical records in hospitals

"Currently electronic medical records (EMRs) are implemented in hospitals, because of 
expected benefits for quality and safety of care...This paper quantifies the relative importance of known barriers and facilitators of EMR, experienced by the users (i.e., nurses and physicians in hospitals)"

The preferences of users of electronic medical records in hospitals: quantifying the relative importance of barriers and facilitators of an innovation
MHL Struik, F Koster, AJ Schuit, R Nugteren, J Veldwijk, MS Lambooij
Implementation Science, 2014, 9: 69

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The challenge of change in acute mental health services

"VOCALISE can be used to explore staff perceptions of implementation climate and to assess how staff attitudes shape the successful outcomes of planned changes."

The challenge of change in acute mental health services: measuring staff perceptions of barriers to change and their relationship to job status and satisfaction using a new measure (VOCALISE)
C Laker, F Callard, C Flach, P Williams, J Sayer, T Wykes
Implementation Science, 2014, 9:23

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Factors that prevent or enable improvements in healthcare professional practice

"Based on a systematic review and a consensus process we developed a checklist that aims to be comprehensive and to build on the strengths of each of the 12 included checklists. The checklist is accompanied with five worksheets to facilitate its use in implementation research and quality improvement projects."

A checklist for identifying determinants of practice: A systematic review and synthesis of frameworks and taxonomies of factors that prevent or enable improvements in healthcare professional practice
SA Flottorp, AD Oxman, J Krause, NR Musila, M Wensing, M Godycki-Cwirko, R Baker, MP Eccles
Implementation Science, 2013, 8:35

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The barriers to choice review

"In all the public services the review looked at, it was clear that people without access to computers or cars are at a double disadvantage when it comes to exercising choice, and also that making choice more widely available in practice means providing, not just access to information, but access to personal face-to-face interpretation."

The barriers to choice review: how are people using choice in public services?
D Boyle
NHS Alliance
January 2013

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Barriers and facilitators in implementation and diffusion of healthcare service innovations

"The purpose of the present study was to explore how healthcare innovators of process-based initiatives perceived and made sense of factors that either facilitated or obstructed the innovation implementation and diffusion."

Understanding innovators' experiences of barriers and facilitators in implementation and diffusion of healthcare service innovations: a qualitative study
J Barnett, K Vasileiou, F Djemil, L Brooks, T Young
BMC Health Services Research, 2011, 11:342

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