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.


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*