JMIR Publications

ABSTRACT

Background:

A need exists for a hybrid approach between quality improvement (QI) and implementation sciences.

Objective:

This study describes the creation, implementation, and evaluation of a hybrid model for quality improvement and program evaluation to guide scholarship in the Doctor of Nursing Practice Program (DNP) Programs.

Methods:

The hybrid model was based on cross-fertilization between improvement and implementation sciences. The model adapted the Getting to Outcome (GTO) and Knowledge to Action (KTA) models as the overarching process models for knowledge implementation. Within each phase of the GTO and KTA models, expected barriers and facilitators for implementation and adoption of innovation were identified based on the Consolidated Framework for Implementation Research (CFIR). Accordingly, strategies to facilitate implementation and adoption of innovations were identified based on a refined list of implementation strategies and QI tools. The choice of these models was based on the top five criteria for selecting implementation science theories and frameworks. Seven DNP students used the hybrid model to conduct QI projects. Students evaluated their experiences by responding to a Qualtrics survey.

Results:

The hybrid model encouraged a comprehensive systemic way of thinking, provided tools essential to implementation success, emphasized the need for adaptability in implementation, maintained rigor in QI, and guided the sustainability of change. Some of the challenges faced by students include finding reliable and valid measures, attaining and maintaining staff buy-in, and competing organizational priorities.

Conclusions:

Cross-fertilization between improvement and implementation sciences provided a roadmap and systemic thinking for successful QI projects in the DNP program.