title: Harnessing implementation science to improve care quality and patient safety: a systematic review of targeted literature.
abstract: BACKGROUND
  Getting greater levels of evidence into practice is a key problem for health systems, compounded by the volume of research produced. Implementation science aims to improve the adoption and spread of research evidence. A linked problem is how to enhance quality of care and patient safety based on evidence when care settings are complex adaptive systems. Our research question was: according to the implementation science literature, which common implementation factors are associated with improving the quality and safety of care for patients?
  
  
  METHODS
  We conducted a targeted search of key journals to examine implementation science in the quality and safety domain applying PRISMA procedures. Fifty-seven out of 466 references retrieved were considered relevant following the application of exclusion criteria. Included articles were subjected to content analysis. Three reviewers extracted and documented key characteristics of the papers. Grounded theory was used to distil key features of the literature to derive emergent success factors.
  
  
  RESULTS
  Eight success factors of implementation emerged: preparing for change, capacity for implementation-people, capacity for implementation-setting, types of implementation, resources, leverage, desirable implementation enabling features, and sustainability. Obstacles in implementation are the mirror image of these: for example, when people fail to prepare, have insufficient capacity for implementation or when the setting is resistant to change, then care quality is at risk, and patient safety can be compromised.
  
  
  CONCLUSIONS
  This review of key studies in the quality and safety literature discusses the current state-of-play of implementation science applied to these domains.
authors.affiliation: Centre for Clinical Governance Research, Australian Institute of Health Innovation, University of New South Wales, Sydney, NSW 2052, Australia.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Braithwaite
authors.affiliation: Centre for Clinical Governance Research, Australian Institute of Health Innovation, University of New South Wales, Sydney, NSW 2052, Australia.
authors.forename: Danielle
authors.initials: D
authors.lastname: Marks
authors.affiliation: Centre for Clinical Governance Research, Australian Institute of Health Innovation, University of New South Wales, Sydney, NSW 2052, Australia Bradford Institute for Health Research, Bradford, UK.
authors.forename: Natalie
authors.initials: N
authors.lastname: Taylor
mesh_terms: D055317:Evidence-Based Practice; D006801:Humans; D009936:Organizational Innovation; D061214:Patient Safety; D058996:Quality Improvement; D057170:Translational Research, Biomedical
keywords: appropriate healthcare; patient safety