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. 2019 May/Jun;34(3):293-306.
doi: 10.1177/1062860618798469. Epub 2018 Sep 10.

Innovative Implementation Studies Conducted in US Safety Net Health Care Settings: A Systematic Review

Courtney R Lyles  1 , Margaret A Handley  1 , Sara L Ackerman  1 , Dean Schillinger  1 , Pamela Williams  1 , Marisa Westbrook  2 , Gato Gourley  1 , Urmimala Sarkar  1
Affiliations

Innovative Implementation Studies Conducted in US Safety Net Health Care Settings: A Systematic Review

Courtney R Lyles et al. Am J Med Qual. 2019 May/Jun.

Abstract

Little is known about dissemination and implementation in safety net settings. The authors conducted a literature review of innovation/implementation studies in US safety net health care settings between 2008 and 2017. Each article was coded for (1) intervention characteristics, (2) implementation stage, (3) internal versus external ownership, and (4) prespecified implementation outcomes (eg, acceptability and fidelity). Twenty studies were identified; the majority were implemented within community clinics or integrated safety net systems (15 articles), most involved care process improvements (13 articles), and most were internally developed (13 articles). The internally developed innovations reported fewer barriers to acceptability among staff/providers, higher leadership involvement and organizational alignment, greater amounts of customization to the local setting, and better sustainment. Future work should harness the high levels of alignment and acceptability in implementation research within safety net settings, with an eye toward maintaining fidelity to facilitate dissemination across sites.

Keywords: care process innovations; implementation science; safety net; systematic review.

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Conflict of interest statement

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Manuscript selection flow diagram.
See this image and copyright information in PMC

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