BACKGROUND Innovations to improve quality and safety in healthcare are increasingly complex, targeting multiple disciplines and organizational levels, and often requiring significant behavior change by those delivering care. Learning health systems must tackle the crucial task of understanding the implementation and effectiveness of complex interventions, but may be hampered in their efforts by limitations in study design imposed by business-cycle timelines and implementation into fast-paced clinical environments. Rapid assessment procedures are a pragmatic option for producing timely, contextually rich evaluative information about complex interventions implemented into dynamic clinical settings. METHODS We describe our adaptation of rapid assessment procedures and introduce a rapid team-based analysis process using an example of an evaluation of an intensive care unit (ICU) redesign initiative aimed at improving patient safety in four academic medical centers across the USA. Steps in our approach included (1) iteratively working with stakeholders to develop evaluation questions; (2) integration of implementation science frameworks into field guides and analytic tools; (3) selecting and training a multidisciplinary site visit team; (4) preparation and trust building for 2-day site visits; (5) engaging sites in a participatory approach to data collection; (6) rapid team analysis and triangulation of data sources and methods using a priori charts derived from implementation frameworks; and (7) validation of findings with sites. RESULTS We used the rapid assessment approach at each of the four ICU sites to evaluate the implementation of the sites' innovations. Though the ICU projects all included three common components, they were individually developed to suit the local context and had mixed implementation outcomes. We generated in-depth case summaries describing the overall implementation process for each site; implementation barriers and facilitators for all four sites are presented. One of the site case summaries is presented as an example of findings generated using the method. CONCLUSIONS A rapid team-based approach to qualitative analysis using charts and team discussion using validation techniques, such as member-checking, can be included as part of rapid assessment procedures. Our work demonstrates the value of including rapid assessment procedures for implementation research when time and resources are limited.

中文翻译：

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使用基于团队的分析方法调整实施研究的快速评估程序：ICU 患者质量和安全干预措施的案例。


背景技术旨在提高医疗保健质量和安全性的创新日益复杂，针对多个学科和组织级别，并且通常需要提供护理的人员显着改变行为。学习型卫生系统必须解决了解复杂干预措施的实施和有效性的关键任务，但其努力可能会因商业周期时间表和快节奏临床环境实施所施加的研究设计限制而受到阻碍。快速评估程序是一种实用的选择，可以生成及时、上下文丰富的有关在动态临床环境中实施的复杂干预措施的评估信息。方法 我们描述了我们对快速评估程序的调整，并以评估重症监护病房 (ICU) 重新设计计划为例介绍了基于团队的快速分析流程，该计划旨在提高美国四个学术医疗中心的患者安全。我们方法的步骤包括（1）与利益相关者反复合作以制定评估问题； (2) 将实施科学框架纳入现场指南和分析工具； （三）选拔和培训多学科现场考察团队； (4) 为期 2 天的实地考察的准备和建立信任； (5) 让站点采用参与式数据收集方法； (6) 使用源自实施框架的先验图表对数据源和方法进行快速团队分析和三角测量； (7) 现场验证调查结果。结果 我们在四个 ICU 站点中的每一个站点都使用了快速评估方法来评估站点创新的实施情况。 尽管 ICU 项目都包含三个共同组成部分，但它们是根据当地情况单独开发的，并且实施结果参差不齐。我们生成了深入的案例摘要，描述了每个站点的整体实施流程；介绍了所有四个地点的实施障碍和促进因素。其中一个现场案例摘要作为使用该方法生成的结果的示例进行了介绍。结论 基于团队的快速定性分析方法，使用图表和团队讨论，使用验证技术（例如成员检查），可以作为快速评估程序的一部分。我们的工作证明了在时间和资源有限的情况下为实施研究纳入快速评估程序的价值。