Building Capacity to Use Evidence-Informed Approaches to Implementation in Maternal-Newborn Care: Development and Evaluation of an Implementation Toolkit

Abstract

Background: Pregnant and birthing people and their infants do not always receive care that aligns with best available evidence. Knowledge generated from implementation science can inform how to close these evidence-practice gaps. However, the implementation science literature is large and difficult to navigate, and there are limited opportunities for healthcare providers and leaders to learn about it.

Purpose: To develop and evaluate a toolkit to build the capacity of healthcare professionals and leaders to apply knowledge from implementation science in Ontario maternal-newborn hospital settings.

Methods: A multi-stage, mixed-methods study using an integrated knowledge translation approach. Stage 1 informed the content of the toolkit: (1) a mixed-methods study with implementation experts to identify essential content for teaching implementation practice; (2) a secondary qualitative analysis of interviews with maternal-newborn nursing leaders to learn about implementation approaches; (3) a cross-sectional survey of maternal-newborn healthcare professionals and leaders on their implementation approaches and learning needs. Stage 2 involved synthesizing the findings and co-producing the toolkit, grounded in the Implementation Roadmap. Stage 3 was a mixed-methods evaluation of the toolkit to assess acceptability, appropriateness, feasibility, usability, and intent to use.

Findings: 137 people were enrolled (33 implementation experts; 104 maternal-newborn healthcare professionals and leaders). Implementation experts identified core content needed to teach healthcare professionals about implementation. The secondary qualitative analysis and survey confirmed that current approaches to implementing evidence-informed practices do not fully align with recommendations from implementation science. Participants expressed a desire for improving their capacity to apply evidence-informed implementation approaches. Data from Stage 1 was synthesized to create a toolkit with 13 steps and 26 templates to support teams to improve their implementation processes. Evaluation participants indicated the toolkit is an acceptable and helpful resource that they intend to use and identified areas to improve usability and feasibility.

Conclusions: Knowledge from implementation science is not being applied consistently or comprehensively in Ontario maternal-newborn hospital settings. The toolkit is an implementation strategy that can help translate knowledge from implementation science into practice. Future work is needed to refine the toolkit, field-test it, and ascertain its effectiveness to improve implementation capacity, processes, and outcomes.