SynthesisImplementation science : IS2020
Avoiding unnecessary hospitalisation for patients with chronic conditions: a systematic review of implementation determinants for hospital avoidance programmes.
Synthesis in Implementation science : IS, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Barriers and Facilitators to the Adoption of Evidence-Based Interventions for Adults Within Occupational and Physical Therapy Practice Settings: A Systematic Review.Archives of physical medicine and rehabilitation · 2023Pooled it
- Implementation of a complex intervention to reduce hospitalizations from nursing homes: a mixed-method evaluation of implementation processes and outcomes.BMC geriatrics · 2022Trial
- Trial
- Automated Waitlists for Ambulatory Appointment Scheduling: Multisite, Mixed Methods Evaluation.Journal of medical Internet research · 2026Article
- Article
- Tracing the threads: a system dynamics and network diffusion model of kangaroo care implementation in neonatal care.Implementation science communications · 2026Article
- Time to care: the lived experience of receiving care from a primary care service for people with frequent hospital admissions.Family medicine and community health · 2026Article
- Article
- Continuous quality improvement across a South Australian health service and the role it plays in a learning health system: a qualitative study.BMC health services research · 2025Article
- Theory-informed process evaluation protocol to assess a rapid-access outpatient model of care in South East Queensland, Australia.BMJ open · 2025Article
- Exploring the User Acceptability and Feasibility of a Clinical Decision Support Tool Designed to Facilitate Timely Diagnosis of New-Onset Type 1 Diabetes in Children: Qualitative Interview Study Among General Practitioners.JMIR formative research · 2024Article
- Implementation of large, multi-site hospital interventions: a realist evaluation of strategies for developing capability.BMC health services research · 2024Article
- Four System Enablers of Large-System Transformation in Health Care: A Mixed Methods Realist Evaluation.The Milbank quarterly · 2024Review
- Audit and feedback to reduce unwarranted clinical variation at scale: a realist study of implementation strategy mechanisms.Implementation science : IS · 2023Article
- International Atherosclerosis Society guidance for implementing best practice in the care of familial hypercholesterolaemia.Nature reviews. Cardiology · 2023Review
- Clinicians' Perspective on Implementing Virtual Hospital Care for Low Back Pain: Qualitative Study.JMIR rehabilitation and assistive technologies · 2023Article
- Diabetes Specialists Value Continuous Glucose Monitoring Despite Challenges in Prescribing and Data Review Process.Journal of diabetes science and technology · 2023Article
- Article
- Scaling-up and future sustainability of a national reproductive genetic carrier screening program.NPJ genomic medicine · 2023Article
- Strategic Priorities for Implementation of Father-Inclusive Practice in Mental Health Services for Children and Families: A Delphi Expert Consensus Study.Administration and policy in mental health · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStudies of clinical effectiveness have demonstrated the many benefits of programmes that avoid unnecessary hospitalisations. Therefore, it is imperative to examine the factors influencing implementation of these programmes to ensure these benefits are realised across different healthcare contexts and settings. Numerous factors may act as determinants of implementation success or failure (facilitators and barriers), by either obstructing or enabling changes in healthcare delivery. Understanding the relationships between these determinants is needed to design and tailor strategies that integrate effective programmes into routine practice. Our aims were to describe the implementation determinants for hospital avoidance programmes for people with chronic conditions and the relationships between these determinants.
methodsAn electronic search of four databases was conducted from inception to October 2019, supplemented by snowballing for additional articles. Data were extracted using a structured data extraction tool and risk of bias assessed using the Hawker Tool. Thematic synthesis was undertaken to identify determinants of implementation success or failure for hospital avoidance programmes for people with chronic conditions, which were categorised according to the Consolidated Framework for Implementation Research (CFIR). The relationships between these determinants were also mapped.
resultsThe initial search returned 3537 articles after duplicates were removed. After title and abstract screening, 123 articles underwent full-text review. Thirteen articles (14 studies) met the inclusion criteria. Thematic synthesis yielded 23 determinants of implementation across the five CFIR domains. 'Availability of resources', 'compatibility and fit', and 'engagement of interprofessional team' emerged as the most prominent determinants across the included studies. The most interconnected implementation determinants were the 'compatibility and fit' of interventions and 'leadership influence' factors.
conclusionsEvidence is emerging for how chronic condition hospital avoidance programmes can be successfully implemented and scaled across different settings and contexts. This review provides a summary of key implementation determinants and their relationships. We propose a hypothesised causal loop diagram to represent the relationship between determinants within a complex adaptive system.
trial registrationPROSPERO 162812.
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What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.