Methods progress note: Applying dissemination and implementation science models to enhance hospital‐based quality improvement

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SUMMARY

D&I Models are great tools to guide both QI and research project planning, implementation, and evaluation in hospital medicine. Using D&I Models can ensure that you measure what matters to key partners, consider context, rapidly identify and address barriers, and monitor for disparities in implementation. In this way, D&I Models facilitate equitable implementation of interventions and contribute to both the quality and sustainability of healthcare.

INTRODUCTION

Quality improvement (QI) is well recognized as essential to improving care delivery within health systems. However, QI initiatives often fail or are not maintained beyond initial implementation. The fields of dissemination and implementation (D&I) science and QI share the common goal of improving care delivery.¹ D&I models are increasingly used to guide the procedures and measures used in QI projects to facilitate the equitable implementation, spread, and sustainment of QI initiatives. This article is meant to serve as a practical introduction to D&I models for hospitalists engaged in QI and/or research efforts.

D&I science was developed to address the pervasive delay between the discovery of knowledge and its actual application to improve the human condition. This phenomenon is often referred to as the “evidence to practice” gap, which occurs when evidence-based interventions are developed, tested and published, but then are not taken up into routine practice. Evidence to practice gap exists across disciplines as diverse as public health and agriculture,² but the urgency to address this gap is particularly strong in healthcare. Models and frameworks have been developed to inform the determinants and processes needed for successful implementation. They provide critical guidance to close the evidence to practice gap and have been shown to shorten the time needed to advance research to practice,³ including examples where these methods were used as part of plan-do-study-act (PDSA) QI cycles.⁴

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