Use of implementation science frameworks to identify core components and sustainability characteristics of a quality improvement learning collaborative.

Abstract

Background: Implementation Science (IS) frameworks facilitate definition of core and optional components of innovations, interventions and programmes, which increases the likelihood of successful implementation and sustainment. We used IS frameworks to characterise a hospital-based interdisciplinary quality improvement learning collaborative (QILC) which was established to develop quality improvement (QI) capability among front-line staff. The aim was to identify factors that supported implementation, potential threats to sustainability and elements that may influence dissemination into other settings.

Methods: Of five IS frameworks evaluated, two were selected, the Active Implementation Framework (action-oriented, dependent on feedback loops and improvement cycles) and the Consolidated Framework for Implementation Research (enabled definition of core components). The QILC was mapped against the drivers and constructs of each.

Results: Factors relating to the QILC's leadership; the generation of tension for change; and the use of both internal and external networks were central features in implementation. Key drivers included the characteristics of front-line ownership, iterative development and tribality of the QILC, each being central to QI methodology. Risks to sustainability included patchy implementation, a requirement for greater alignment with organisational priorities, requirement for coaching and recruitment of additional leaders to support succession planning.

Conclusions: IS provided frameworks for retrospective analysis of a QI learning collaborative and identified factors that threaten sustainability. This analysis should help guide formative evaluations of similar QI learning collaboratives and offer an organisational framework to facilitate successful replication within different parts of an organisation and across multiple settings.