title: Best practice implementation: lessons learned from 20 partnerships.
abstract: 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.
authors.affiliation: Department of Pediatrics, Stanford University School of Medicine, Stanford California, USA. psharek@LPCH.org
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Sharek
authors.forename: Charlotte
authors.initials: C
authors.lastname: Mullican
authors.forename: Angela
authors.initials: A
authors.lastname: Lavanderos
authors.forename: Cynthia
authors.initials: C
authors.lastname: Palmer
authors.forename: Vincenza
authors.initials: V
authors.lastname: Snow
authors.forename: Karen
authors.initials: K
authors.lastname: Kmetik
authors.forename: Mark
authors.initials: M
authors.lastname: Antman
authors.forename: David
authors.initials: D
authors.lastname: Knutson
authors.forename: Louise Marie
authors.initials: LM
authors.lastname: Dembry
mesh_terms: 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