SURGICAL PERSPECTIVE Leveraging the Theoretical Domains Framework to Facilitate Evidence-based Surgical Practice Dana A. Telem, MD, MPH, y Justin Dimick, MD, MPH, y and Ted A. Skolarus, MD, MPHz§ Keywords: guidelines, implementation, implementation science, Framework, Reach, Effectiveness, Adoption, Implementation and intervention, theoretical domains framework Maintenance (RE-AIM), Precede-Proceed; Robust Implementation Sustainability Model (PRISM); and the Consolidated Framework for (Ann Surg 2018;267:432–434) Implementation Research (CFIR). For the purpose of this paper, we focus on the Theoretical Domains Framework (TDF), given its ties to s a surgical community, we strive to provide the best quality of evidence-based behavior change techniques. Leveraging the TDF, we A surgical care for our patients. We identify gaps within our propose a stepwise approach to designing implementation interven- practices and opportunities to improve outcomes. We create evi- tions and strategies relevant for the surgical provider. dence-based practice recommendations to improve patient care. However, most times, we stop there, assuming such recommenda- Step 1—Identifying the Practice Gap: Who Needs tions will be readily adopted, but more often than not they aren’t. to do What Differently? Although evidence-based practice recommendations are rec- Identifying practice gaps is a familiar domain to many sur- ognized to minimize unwarranted healthcare variation and
Annals of Surgery – Wolters Kluwer Health
Published: Mar 1, 2018
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