Best practice implementation: lessons learned from 20 partnerships.
BACKGROUND
Partnerships can facilitate effective implementation of best practices, but literature describing effective and ineffective strategies to address barriers to implementation in partnerships is lacking.


METHODS
Principal investigators (PIs) were surveyed to identify barriers to best practice implementation, rank their significance, and articulate the success and failure of solutions attempted.


RESULTS
The top four categories of barriers to implementation were partnership challenges, practitioner/local organization variables, time frame challenges, and financial concerns. Ninety-eight effective and 38 ineffective solutions used to overcome these barriers were identified. The most common categories of successful solutions were flexibility of interventions to align with unique local characteristics, schedules, and budgets (36.7% of listed successful solutions); communication strategies that emphasize frequent bidirectional information exchange in person (26.5%); and thoughtful use of personnel emphasizing sites' senior leadership and centralized quality and analytic content expertise (16.3%).


CONCLUSIONS
Despite substantial partnership diversity, consistent themes related to barriers to implementation and solutions to these barriers emerged. The successful and unsuccessful solutions provided should be proactively assessed to enhance the likelihood of future partnership success.
Sharek
Paul J
PJ
Department of Pediatrics, Stanford University School of Medicine, Stanford California, USA. psharek@LPCH.org
Mullican
Charlotte
C
Lavanderos
Angela
A
Palmer
Cynthia
C
Snow
Vincenza
V
Kmetik
Karen
K
Antman
Mark
M
Knutson
David
D
Dembry
Louise Marie
LM
D019985:Benchmarking; D003159:Community-Institutional Relations; D003299:Cooperative Behavior; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine; D006302:Health Services Research / Q000458:organization & administration*; D006801:Humans; D007373:Interinstitutional Relations; D009936:Organizational Innovation; D009937:Organizational Objectives; D015397:Program Evaluation; D011785:Quality Assurance, Health Care; D011795:Surveys and Questionnaires; D014481:United States; D016270:United States Agency for Healthcare Research and Quality