Abstract
Health and social care Standards are evidence-based statements that demonstrate a desired level of care. Setting Standards for health and social care is a mechanism by which quality improvements can be achieved. Limited evidence exists on appropriate implementation strategies to overcome challenges with implementing Standards. The aim of this protocol is to set out a comprehensive plan to undertake a systematic search, appraisal and mixed research synthesis of the international literature that examines factors that hinder and facilitate implementation of health and social care Standards in order to inform the design of implementation strategies. A research question, "What are the enablers and barriers to implementing health and social care Standards in health and social care services?" was designed using the 'SPICE' (Setting, Perspectives, Interest phenomenon of, Comparison, Evaluation) framework. Electronic databases, grey literature and reference lists from included studies will be searched. Primary qualitative, quantitative descriptive and mixed methods studies reporting on enablers and barriers to implementing nationally endorsed Standards, will be included. The review will focus on experiences and perspectives from multi-level stakeholders including patient and public involvement. The quality of studies will be appraised using appropriate tools and findings used to weight interpretation of findings. Search outputs, data extraction and quality appraisal will be undertaken by two reviewers independently. Sandelowski meta-summary will be used to synthesise the data. Frequency and intensity effect sizes of enablers and barriers will be calculated to evaluate their prevalence across the studies. The Confidence in Evidence from Reviews of Qualitative research (CERQual) approach will be applied to assess confidence in the findings of the review. Findings from this examination will inform influencing factors to implementation. Subsequently, this will contribute to pairing Standards with appropriate implementation strategies that will optimise the enabling factors and overcome challenges to implementation.
Highlights
Health and social care Standards are evidence-based statements that demonstrate a desired level of care
Aim The aim of this protocol is to describe the methodological plan for conducting a systematic review and meta-summary that seeks to identify, describe and synthesise the enablers and barriers that influence implementation of health and social care Standards, from the international literature, in order to inform the development of tailored implementation strategies
This review examined how international Standards-setting bodies develop Standards and guidance for health and social care services and included 13 organisations from nine jurisdictions[27]
Summary
Current implementation research addresses components of implementation science in relation to enablers and barriers with specific healthcare interventions or activities including guidelines, evidence-based practices and quality improvement projects While these specific interventions might share some attributes with health and social care Standards e.g. evidence based practice, they do not always demand the multi-level stakeholder buy-in and diverse services that are inherent in Standards. This mixed research synthesis is deemed an appropriate fit for this review in that it will facilitate collation of the findings from multiple empirical studies carried out in various settings It will allow for the identification of viewpoints, be they contradictory or consistent, from a range of stakeholders from both the supply and demand side of health and social care, identifying factors that act as barriers and/or enablers. Aim The aim of this protocol is to describe the methodological plan for conducting a systematic review and meta-summary that seeks to identify, describe and synthesise the enablers and barriers that influence implementation of health and social care Standards, from the international literature, in order to inform the development of tailored implementation strategies
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