Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Jul 13;2(2):e000269.
doi: 10.1136/bmjgh-2016-000269. eCollection 2017.

Using the Consolidated Framework for Implementation Research to implement and evaluate national surgical planning

Saurabh Saluja  1   2   3 , Allison Silverstein  2   4 , Swagoto Mukhopadhyay  2   3   5 , Yihan Lin  2   6 , Nakul Raykar  2   7 , Salmaan Keshavjee  3 , Lubna Samad  3   8 , John G Meara  2   3   9
Affiliations
Review

Using the Consolidated Framework for Implementation Research to implement and evaluate national surgical planning

Saurabh Saluja et al. BMJ Glob Health. .

Abstract

The Lancet Commission on Global Surgery defined six surgical indicators and a framework for a national surgical plan that aimed to incorporate surgical care as a part of global public health. Multiple countries have since begun national surgical planning; each faces unique challenges in doing so. Implementation science can be used to more systematically explain this heterogeneous process, guide implementation efforts and ultimately evaluate progress. We describe our intervention using the Consolidated Framework for Implementation Research. This framework requires identifying characteristics of the intervention, the individuals involved, the inner and outer setting of the intervention, and finally describing implementation processes. By hosting a consultative symposium with clinicians and policy makers from around the world, we are able to specify key aspects of each element of this framework. We define our intervention as the incorporation of surgical care into public health planning, identify local champions as the key individuals involved, and describe elements of the inner and outer settings. Ultimately we describe top-down and bottom-up models that are distinct implementation processes. With the Consolidated Framework for Implementation Research, we are able to identify specific strategic models that can be used by implementers in various settings. While the integration of surgical care into public health throughout the world may seem like an insurmountable challenge, this work adds to a growing effort that seeks to find a way forward.

Keywords: Health policy; Health systems; Public Health; Surgery.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
A worksheet for understanding national surgical planning using the Consolidated Framework for Implementation Research. LCoGS, Lancet Commission on Global Surgery.
Figure 2
Figure 2
Top-down approach to national surgical planning.
Figure 3
Figure 3
Bottom-up approach to national surgical planning.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Meara JG, Leather AJM, Hagander L, et al. . Global surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet 2015;286:569–624. 10.1016/j.ijoa.2015.09.006 - DOI - PubMed
    1. Eccles MP, Mittman BS. Welcome to Implementation Science. Implementation Science 2006;1:1:1 10.1186/1748-5908-1-1 - DOI
    1. Proctor E, Silmere H, Raghavan R, et al. . Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health 2011;38:65–76. 10.1007/s10488-010-0319-7 - DOI - PMC - PubMed
    1. Proctor EK, Powell BJ, McMillen JC. Implementation strategies: recommendations for specifying and reporting. Implement Sci 2013;8:139 10.1186/1748-5908-8-139 - DOI - PMC - PubMed
    1. Damschroder LJ, Aron DC, Keith RE, et al. . Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci 2009;4:50 10.1186/1748-5908-4-50 - DOI - PMC - PubMed

LinkOut - more resources