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Implementation Barriers (implementation + barrier)

Distribution by Scientific Domains

Psychology	50%

Selected Abstracts

Providers' Beliefs, Attitudes, and Behaviors before Implementing a Computerized Pneumococcal Vaccination Reminder

ACADEMIC EMERGENCY MEDICINE, Issue 12 2006
Judith W. Dexheimer MS
Abstract Background The emergency department (ED) has been recommended as a suitable setting for offering pneumococcal vaccination; however, implementations of ED vaccination programs remain scarce. Objectives To understand beliefs, attitudes, and behaviors of ED providers before implementing a computerized reminder system. Methods An anonymous, five-point Likert-scale, 46-item survey was administered to emergency physicians and nurses at an academic medical center. The survey included aspects of ordering patterns, implementation strategies, barriers, and factors considered important for an ED-based vaccination initiative as well as aspects of implementing a computerized vaccine-reminder system. Results Among 160 eligible ED providers, the survey was returned by 64 of 67 physicians (96%), and all 93 nurses (100%). The vaccine was considered to be cost effective by 71% of physicians, but only 2% recommended it to their patients. Although 98% of physicians accessed the computerized problem list before examining the patient, only 28% reviewed the patient's health-maintenance section. Physicians and nurses preferred a computerized vaccination-reminder system in 93% and 82%, respectively. Physicians' preferred implementation approach included a nurse standing order, combined with physician notification; nurses, however, favored a physician order. Factors for improving vaccination rates included improved computerized documentation, whereas increasing the number of ED staff was less important. Relevant implementation barriers for physicians were not remembering to offer vaccination, time constraints, and insufficient time to counsel patients. The ED was believed to be an appropriate setting in which to offer vaccination. Conclusions Emergency department staff had favorable attitudes toward an ED-based pneumococcal vaccination program; however, considerable barriers inherent to the ED setting may challenge such a program. Applying information technology may overcome some barriers and facilitate an ED-based vaccination initiative. [source]

Clinical supervision in the alcohol and other drugs field: an imperative or an option?

DRUG AND ALCOHOL REVIEW, Issue 3 2007
ANN M. ROCHE
Abstract There is a growing interest in Clinical Supervision (CS) as a central workforce development (WFD) strategy. This paper provides a definition of and rationale for CS, characterises its various forms, identifies selection and training issues, and advises on policy and implementation issues central to redressing shortcomings in supervision practice within the alcohol and other drugs (AOD) field. Relevant selective literature is reviewed. Key conceptual issues were identified, and strategies developed to address implementation barriers and facilitate relevant policy. There is a common conceptual confusion between administrative supervision and CS. Clarification of the role, function and implementation of CS is required. Priority issues for the AOD field include: enhancing belief in CS; ensuring adequate resource allocation; developing evaluation protocols; and addressing specific arrangements under which supervision should occur. CS has been underutilised to date but holds considerable potential as a WFD strategy. It is fundamental to workers' professional development, can contribute to worker satisfaction and retention, and may improve client outcomes. Critical next steps are to establish the generalisability to the AOD field of the benefits observed from CS in other disciplines, and evaluate longer-term gains of CS programs. [source]

Barriers to implementing e-learning: a Kuwaiti case study

INTERNATIONAL JOURNAL OF TRAINING AND DEVELOPMENT, Issue 1 2008
Ghadah Essa Ali
The paper reports on a research project that encompasses two key objectives: (1) finding out about the barriers affecting or preventing e-learning from being adopted by companies as an integral part of their workforce's training and learning processes and (2) establishing a comparison between the barriers and the e-learning implementation models found in Kuwait and in the practice of Western companies. The practices from Western countries are used as a benchmark for the Kuwaiti experience. The collection of the primary data was carried out through the use of semi-structured questionnaires with human resources managers as well as IT managers in charge of the e-learning of 11 of the largest companies in Kuwait. The research results show that the key implementation barriers in Kuwait are (1) lack of management support; (2) language barriers; (3) IT problems; and (4) workload and lack of time. From these, two are common to Western countries (technology and time). The remaining two (management support and language barriers) are specific to Kuwait. Regarding the comparison between the two implementation models, the key finding was that the usual e-learning development cycle (plan,design,integrate,improve) was not followed in Kuwait. The planning, designing and improving stages were largely ignored, with the emphasis resting almost completely on integrating the e-learning tools and processes in the rest of the organization. This finding was found to be in line with barrier number one , lack of management support. The key lesson learned from this research is that the problem of e-learning implementation in Kuwait is not so much one of knowing what the barriers are but one of knowing what the appropriate management processes should be for companies to achieve business success. The paper also provides recommendations for an e-learning development plan to fit the current business environment in Kuwait. [source]

Considering a multisite study?

JOURNAL OF COMMUNITY PSYCHOLOGY, Issue 2 2002
How to take the leap, have a soft landing
Although most policymakers agree that a fundamental goal of the mental health system is to provide integrated community-based services, there is little empirical evidence with which to plan such a system. Studies in the community mental health literature have not used a standard set of evaluation methods. One way of addressing this gap is through a multisite program evaluation in which multiple sites and programs evaluate the same outcomes using the same instruments and time frame. The proposition of introducing the same study design in different settings and programs is deceptively straightforward. The difficulty is not in the conceptualization but in the implementation. This article examines the factors that act as implementation barriers, how are they magnified in a multisite study design, and how they can be successfully addressed. In discussing the issue of study design, this article considers processes used to address six major types of barriers to conducting collaborative studies identified by Lancaster or Lancaster's six Cs,contribution, communication, compatibility, consensus, credit, and commitment. A case study approach is used to examine implementation of a multisite community mental health evaluation of services and supports (case management, self-help initiatives, crisis interventions) represented by six independent evaluations of 15 community health programs. A principal finding was that one of the main vehicles to a successful multisite project is participation. It is only through participation that Lancaster's six Cs can be addressed. Key factors in large, geographically dispersed, and diverse groups include the use of advisory committees, explicit criteria and opportunities for participation, reliance on all modes of communication, and valuing informal interactions. The article concludes that whereas modern technology has assisted in making complicated research designs feasible, the operationalization of timeless virtues such as mutual respect and trust, flexibility, and commitment make them successful. © 2002 John Wiley & Sons, Inc. [source]