Contextual factors influencing the implementation of the obstetrics hemorrhage initiative in Florida

C A Vamos; E L Thompson; A Cantor; L Detman; E Bronson; A Phelps; J M Louis; A R Gregg; J S Curran; W Sappenfield

doi:10.1038/jp.2016.199

Contextual factors influencing the implementation of the obstetrics hemorrhage initiative in Florida

J Perinatol. 2017 Feb;37(2):150-156. doi: 10.1038/jp.2016.199. Epub 2016 Nov 17.

Authors

C A Vamos¹, E L Thompson¹, A Cantor¹, L Detman^{2

3}, E Bronson³, A Phelps³, J M Louis⁴, A R Gregg⁵, J S Curran⁶, W Sappenfield¹

Affiliations

¹ Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA.
² The Lawton and Rhea Chiles Center for Healthy Mothers and Babies, College of Public Health, University of South Florida, Tampa, FL, USA.
³ Florida Perinatal Quality Collaborative, The Lawton and Rhea Chiles Center for Healthy Mothers and Babies, College of Public Health, University of South Florida, Tampa, FL, USA.
⁴ Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
⁵ Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Florida, Gainesville, FL, USA.
⁶ University of South Florida Health, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.

PMID: 27853321
DOI: 10.1038/jp.2016.199

Abstract

Objective: The purpose of this study was to explore the multilevel contextual factors that influenced the implementation of the Obstetric Hemorrhage Initiative (OHI) among hospitals in Florida.

Study design: A qualitative evaluation was conducted via in-depth interviews with multidisciplinary hospital staff (n=50) across 12 hospitals. Interviews were guided by the Consolidated Framework for Implementation Research and analyzed in Atlas.ti using rigorous qualitative analysis procedures.

Result: Factors influencing OHI implementation were present across process (leadership engagement; engaging people; planning; reflecting), inner setting (for example, knowledge/beliefs; resources; communication; culture) and outer setting (for example, cosmopolitanism) levels. Moreover, factors interacted across levels and were not mutually exclusive. Leadership and staff buy-in emerged as important components influencing OHI implementation across disciplines.

Conclusion: Key contextual factors found to influence OHI implementation experiences can be useful in informing future quality improvement interventions given the institutional and provider-level behavioral changes needed to account for evolving the best practices in perinatology.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Female
Florida
Health Knowledge, Attitudes, Practice*
Health Plan Implementation / organization & administration
Humans
Interdisciplinary Communication*
Interviews as Topic
Perinatology
Personnel, Hospital
Postpartum Hemorrhage / prevention & control*
Postpartum Hemorrhage / therapy*
Pregnancy
Qualitative Research
Quality Improvement / organization & administration*