Evaluating the implementation of health and safety innovations under a regulatory context: A collective case study of Ontario’s safer needle regulation

Implementation Science

Kathryn Nichol²  Linn Holness³  Curtis Breslin¹  Cameron A Mustard¹  Andrea Chambers¹ 

[1] Institute for Work and Health, 481 University Avenue, Suite 800, Toronto, ON, M5G 2E9, Canada;University Health Network, 190 Elizabeth Street, Toronto, ON, M5G 2C4, Canada;Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada

关键词: Hospital;    Case study;    Qualitative;    Implementation;    Regulation;    Safer engineered medical devices;   

Others  :  813823
DOI  :  10.1186/1748-5908-8-9

 received in 2012-11-12, accepted in 2013-01-08,  发布年份 2013

【 摘 要 】

Background

Implementation effectiveness models have identified important factors that can promote the successful implementation of an innovation; however, these models have been examined within contexts where innovations are adopted voluntarily and often ignore the socio-political and environmental context. In the field of occupational health and safety, there are circumstances where organizations must adopt innovations to comply with a regulatory standard. Examining how the external environment can facilitate or challenge an organization’s change process may add to our understanding of implementation effectiveness. The objective of this study is to describe implementation facilitators and barriers in the context of a regulation designed to promote the uptake of safer engineered medical devices in healthcare.

Methods

The proposed study will focus on Ontario’s safer needle regulation (2007) which requires healthcare organizations to transition to the use of safer engineered medical devices for the prevention of needlestick injuries. A collective case study design will be used to learn from the experiences of three acute care hospitals in the province of Ontario, Canada. Interviews with management and front-line healthcare workers and analysis of supporting documents will be used to describe the implementation experience and examine issues associated with the integration of these devices. The data collection and analysis process will be influenced by a conceptual framework that draws from implementation science and the occupational health and safety literature.

Discussion

The focus of this study in addition to the methodology creates a unique opportunity to contribute to the field of implementation science. First, the study will explore implementation experiences under circumstances where regulatory pressures are influencing the organization's change process. Second, the timing of this study provides an opportunity to focus on issues that arise during later stages of implementation, a phase during the implementation cycle that has been understudied. This study also provides the opportunity to examine the relevance and utility of current implementation science models in the field of occupational health where the adoption of an innovation is meant to enhance the health and safety of workers. Previous work has tended to focus almost exclusively on innovations that are designed to enhance an organization’s productivity or competitive advantage.

【 授权许可】

   
2013 Chambers et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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