Kylie Dougherty, Nebiyou Hailemariam, Georgia Jenkins, Junwei Chen, Jackson Ilangali, John Mwangi, Julius Thomas, Hannah Mwaniki Mwaniki, Olabisi Dosunmu, Robert Tillya, Samuel Ngwala, Joy E Lawn, Rebecca Richards-Kortum, Z Maria Oden, Christine Bohne, Lisa R Hirschhorn
{"title":"利用实施科学确定NEST360的模式和结果,以提高该联盟的质量。NEST360是一个旨在降低撒哈拉以南非洲新生儿死亡率的多国联盟。","authors":"Kylie Dougherty, Nebiyou Hailemariam, Georgia Jenkins, Junwei Chen, Jackson Ilangali, John Mwangi, Julius Thomas, Hannah Mwaniki Mwaniki, Olabisi Dosunmu, Robert Tillya, Samuel Ngwala, Joy E Lawn, Rebecca Richards-Kortum, Z Maria Oden, Christine Bohne, Lisa R Hirschhorn","doi":"10.1136/bmjqs-2024-018471","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Improving small and sick newborn care (SSNC) is crucial in resource-limited settings. Newborn Essential Solutions and Technologies (NEST360), a multicountry alliance, aims to reduce newborn mortality through evidence-based interventions. NEST360 developed a multipronged approach to improving quality. We use implementation research (IR) to describe this approach and report emerging implementation outcomes.</p><p><strong>Methods: </strong>The implementation research logic model (IRLM) was applied to link contextual factors, implementation strategies, mechanisms and implementation outcomes, capturing successes and challenges of the improving quality approach. Data sources included programme data, peer-reviewed publications and team input. Contextual factors were organised by the NEST360-UNICEF SSNC implementation toolkit. Strategies were grouped by the Expert Recommendations for Implementation Change list, and implementation outcomes were measured using Proctor's implementation outcomes.</p><p><strong>Results: </strong>We developed an IRLM to describe the implementation of NEST360's improving quality model. This IRLM included 33 contextual factors; 42% were barriers, 42% were facilitators, and 15% were both a barrier and facilitator. Additionally, we identified 10 implementation strategies that NEST360 used. The logic model also describes the connections between the contextual factors, the strategies that address them, and the preliminary implementation outcomes. Examples of the outcomes measured include <i>Reach</i> with 100% of units logging into the NEST360-Implementation Tracker (NEST-IT) at least once (October 2023 to March 2024), <i>Adoption</i> with 100% of units conducting a quality improvement (QI) project (April 2024 to June 2024), and <i>Feasibility</i> with 93% of units reporting NEST-IT data in their QI project documentation (April 2024 to June 2024). Finally, this study identified sustainability strategies as a critical need.</p><p><strong>Conclusions: </strong>Integrating IR and QI enhances SSNC in resource-limited settings. Addressing barriers, leveraging facilitators and using structured IR frameworks advanced QI efforts, thereby improving intervention reach, adoption and feasibility while building scalable systems for high-quality healthcare.</p>","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":""},"PeriodicalIF":5.6000,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Using implementation science to define the model and outcomes for improving quality in NEST360, a multicountry alliance for reducing newborn mortality in sub-Saharan Africa.\",\"authors\":\"Kylie Dougherty, Nebiyou Hailemariam, Georgia Jenkins, Junwei Chen, Jackson Ilangali, John Mwangi, Julius Thomas, Hannah Mwaniki Mwaniki, Olabisi Dosunmu, Robert Tillya, Samuel Ngwala, Joy E Lawn, Rebecca Richards-Kortum, Z Maria Oden, Christine Bohne, Lisa R Hirschhorn\",\"doi\":\"10.1136/bmjqs-2024-018471\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Improving small and sick newborn care (SSNC) is crucial in resource-limited settings. Newborn Essential Solutions and Technologies (NEST360), a multicountry alliance, aims to reduce newborn mortality through evidence-based interventions. NEST360 developed a multipronged approach to improving quality. We use implementation research (IR) to describe this approach and report emerging implementation outcomes.</p><p><strong>Methods: </strong>The implementation research logic model (IRLM) was applied to link contextual factors, implementation strategies, mechanisms and implementation outcomes, capturing successes and challenges of the improving quality approach. Data sources included programme data, peer-reviewed publications and team input. Contextual factors were organised by the NEST360-UNICEF SSNC implementation toolkit. Strategies were grouped by the Expert Recommendations for Implementation Change list, and implementation outcomes were measured using Proctor's implementation outcomes.</p><p><strong>Results: </strong>We developed an IRLM to describe the implementation of NEST360's improving quality model. This IRLM included 33 contextual factors; 42% were barriers, 42% were facilitators, and 15% were both a barrier and facilitator. Additionally, we identified 10 implementation strategies that NEST360 used. The logic model also describes the connections between the contextual factors, the strategies that address them, and the preliminary implementation outcomes. Examples of the outcomes measured include <i>Reach</i> with 100% of units logging into the NEST360-Implementation Tracker (NEST-IT) at least once (October 2023 to March 2024), <i>Adoption</i> with 100% of units conducting a quality improvement (QI) project (April 2024 to June 2024), and <i>Feasibility</i> with 93% of units reporting NEST-IT data in their QI project documentation (April 2024 to June 2024). Finally, this study identified sustainability strategies as a critical need.</p><p><strong>Conclusions: </strong>Integrating IR and QI enhances SSNC in resource-limited settings. Addressing barriers, leveraging facilitators and using structured IR frameworks advanced QI efforts, thereby improving intervention reach, adoption and feasibility while building scalable systems for high-quality healthcare.</p>\",\"PeriodicalId\":9077,\"journal\":{\"name\":\"BMJ Quality & Safety\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.6000,\"publicationDate\":\"2025-05-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMJ Quality & Safety\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/bmjqs-2024-018471\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Quality & Safety","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/bmjqs-2024-018471","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Using implementation science to define the model and outcomes for improving quality in NEST360, a multicountry alliance for reducing newborn mortality in sub-Saharan Africa.
Background: Improving small and sick newborn care (SSNC) is crucial in resource-limited settings. Newborn Essential Solutions and Technologies (NEST360), a multicountry alliance, aims to reduce newborn mortality through evidence-based interventions. NEST360 developed a multipronged approach to improving quality. We use implementation research (IR) to describe this approach and report emerging implementation outcomes.
Methods: The implementation research logic model (IRLM) was applied to link contextual factors, implementation strategies, mechanisms and implementation outcomes, capturing successes and challenges of the improving quality approach. Data sources included programme data, peer-reviewed publications and team input. Contextual factors were organised by the NEST360-UNICEF SSNC implementation toolkit. Strategies were grouped by the Expert Recommendations for Implementation Change list, and implementation outcomes were measured using Proctor's implementation outcomes.
Results: We developed an IRLM to describe the implementation of NEST360's improving quality model. This IRLM included 33 contextual factors; 42% were barriers, 42% were facilitators, and 15% were both a barrier and facilitator. Additionally, we identified 10 implementation strategies that NEST360 used. The logic model also describes the connections between the contextual factors, the strategies that address them, and the preliminary implementation outcomes. Examples of the outcomes measured include Reach with 100% of units logging into the NEST360-Implementation Tracker (NEST-IT) at least once (October 2023 to March 2024), Adoption with 100% of units conducting a quality improvement (QI) project (April 2024 to June 2024), and Feasibility with 93% of units reporting NEST-IT data in their QI project documentation (April 2024 to June 2024). Finally, this study identified sustainability strategies as a critical need.
Conclusions: Integrating IR and QI enhances SSNC in resource-limited settings. Addressing barriers, leveraging facilitators and using structured IR frameworks advanced QI efforts, thereby improving intervention reach, adoption and feasibility while building scalable systems for high-quality healthcare.
期刊介绍:
BMJ Quality & Safety (previously Quality & Safety in Health Care) is an international peer review publication providing research, opinions, debates and reviews for academics, clinicians and healthcare managers focused on the quality and safety of health care and the science of improvement.
The journal receives approximately 1000 manuscripts a year and has an acceptance rate for original research of 12%. Time from submission to first decision averages 22 days and accepted articles are typically published online within 20 days. Its current impact factor is 3.281.