Background

Implementation factors are hypothesised to moderate the implementation of innovations. Although individual barriers and facilitators have been identified for the implementation of different evidence-based services in pharmacy, relationships between implementation factors are usually not considered.

Objectives

To examine how a network of implementation factors and the position of each factor within this network structure influences the implementation of a medication review service in community pharmacy.

Methods

A mixed methods approach was used. Medication review with follow-up service was the innovation to be implemented over 12 months in community pharmacies. A network analysis to model relationships between implementation factors was undertaken. Two networks were created.

Results

Implementation factors hindering the service implementation with the highest centrality measures were time, motivation, recruitment, individual identification with the organization and personal characteristics of the pharmacists. Three hundred and sixty-nine different interrelationships between implementation factors were identified. Important causal relationships between implementation factors included: workflow-time; characteristics of the pharmacy-time; personal characteristics of the pharmacists-motivation.

Implementation factors facilitating the implementation of the service with highest centrality scores were motivation, individual identification with the organization, beliefs, adaptability, recruitment, external support and leadership. Four hundred and fifty-six different interrelationships were identified. The important causal relationships included: motivation-external support; structure-characteristics of the pharmacy; demographics-location of the pharmacy.

Conclusion

Network analysis has proven to be a useful technique to explore networks of factors moderating the implementation of a pharmacy service. Relationships were complex with most implementation factors being interrelated. Motivation and individual identification with the organisation seemed critical factors in both hindering and facilitating the service implementation. The results can inform the design of implementation programs and tailored strategies to promote faster implementation of innovations in pharmacy.

中文翻译：

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使用网络分析探讨影响社区药房药物审查服务实施的因素

背景

实施因素被假设为调节创新的实施。尽管已经确定了在药房实施不同循证服务的个别障碍和促进因素，但通常不考虑实施因素之间的关系。

目标

研究实施因素网络以及每个因素在该网络结构中的位置如何影响社区药房中药物审查服务的实施。

方法

使用了混合方法方法。药物复查和跟踪服务是社区药房在 12 个月内实施的创新。进行了网络分析以模拟实施因素之间的关系。创建了两个网络。

结果

阻碍具有最高中心性措施的服务实施的实施因素是时间、动机、招聘、对组织的个人认同和药剂师的个人特征。确定了实施因素之间的 369 种不同的相互关系。实施因素之间的重要因果关系包括：工作流程时间；药房时间的特点；药剂师的个人特征——动机。

促进中心性得分最高的服务实施的实施因素是动机、个人对组织的认同、信念、适应性、招聘、外部支持和领导力。确定了 456 种不同的相互关系。重要的因果关系包括：动机-外部支持；药房的结构特征；人口统计 - 药房的位置。

结论

网络分析已被证明是一种有用的技术，可以探索影响药房服务实施的因素网络。关系很复杂，大多数实施因素相互关联。动机和个人对组织的认同似乎是阻碍和促进服务实施的关键因素。结果可以为实施计划的设计和量身定制的策略提供信息，以促进更快地实施药学创新。