Nancy D. Sharp,VA Puget Sound Health Care System and Department of Health Services, University of Washington, Seattle, WA.Sandra L. Pineros,VA Puget Sound Health Care System, Seattle, WA.Clarissa Hsu,Group Health Community Foundation, Seattle, WA.Helene Starks,Department of Health Services, University of Washington, Seattle, WA.Anne E. Sales,VA Puget Sound Health Care System and Department of Health Services, University of Washington, Seattle, WA.
A Qualitative Study to Identify Barriers and Facilitators to Implementation of Pilot Interventions in the Veterans Health Administration (VHA) Northwest Network
Article first published online: 21 MAY 2004
Worldviews on Evidence-Based Nursing
Volume 1, Issue 2, pages 129–139, June 2004
How to Cite
Sharp, N. D., Pineros, S. L., Hsu, C., Starks, H. and Sales, A. E. (2004), A Qualitative Study to Identify Barriers and Facilitators to Implementation of Pilot Interventions in the Veterans Health Administration (VHA) Northwest Network. Worldviews on Evidence-Based Nursing, 1: 129–139. doi: 10.1111/j.1741-6787.2004.04023.x
- Issue published online: 21 MAY 2004
- Article first published online: 21 MAY 2004
- Submitted 23 January 2004; Accepted 26 February 2004
- cardiovascular disease;
- evidence-based practice;
- qualitative study
Objective: To identify barriers and facilitators to implementation of pilot interventions designed to improve measurement and management of low-density lipoprotein cholesterol (LDL-c) levels in coronary heart disease patients using the evidence/context/facilitation model of implementation of evidence-based practice.
Design: Theory-based conceptual content analysis of structured interviews conducted between January and April 2001.
Setting: Six medical centers in the United States Veterans Health Administration Northwest Network.
Participants: Fifty-one of 64 individuals (physicians, nurses, pharmacists, dieticians, quality managers, and other clinical and nonclinical staff) who participated in planning and/or implementing pilot interventions.
Main Findings: Barriers to successful implementation related primarily to the intervention process and secondarily to characteristics of the intervention context. Interview responses indicated that planning, including identification of resources and assessment of potential barriers and facilitators, was a critical and universally underutilized step in the intervention process.
Conclusions: Organized team process, documented plans for intervention activities, and ongoing evaluation are essential for sustaining intervention activities. A top priority for facilitating interventions should be the development of educational materials, such as “how to” guides, that teach intervention teams how to anticipate barriers and make plans to address them, as well as identifying and fostering local experts in planning and implementing interventions.