DOI: 10.1177/26334895261499601 ISSN: 2633-4895

How Are Healthcare, Public Health, and Social Services Organizations’ Continuous Use of Evidence-Based Interventions and Practice Improvement Supported? A Scoping Review

Veronica-Aurelia Costea, Adrienne Young, Angela Byrnes, Sally Eames, Nina Meloncelli, Leif Eriksson, Annika Bäck, Henna Hasson, Alison Mudge, Anna Bergström
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Background

Many organizations in health and social services lack strong implementation and QI capacity, that is, the capability to effectively align practice with changing evidence and contexts and thereby continuously improve services and outcomes without external expert assistance. This study maps the characteristics of capacity building interventions (CBIs) aimed at developing generic implementation or quality improvement (QI) capacity, examines how their content aligns with implementation practice competencies, and how they are evaluated.

Method

We followed the Joanna Briggs Institute scoping review methodology. Two searches (most recent 19/4/2024) were conducted in three databases. Empirical articles describing the development and implementation and/or evaluation of generic implementation or QI CBIs delivered to individuals, teams, and/or organizations in healthcare, public health, and social services were included. Data were analyzed using quantitative description and content analysis.

Results

Data were extracted from 160 articles. Most CBIs were delivered in high-income countries ( n  = 145, 91%), in healthcare settings ( n  = 121, 76%), and to clinicians ( n  = 74, 46%). CBIs usually target the individual level ( n  = 63, 39%) or the individual and team levels ( n  = 45, 28%). A combination of capacity-building strategies was generally used rather than a single strategy. Most content and activities aligned with analytical and planning competencies, with only a few emphasizing relational and emotional competencies, planning for sustainability, and knowledge brokering skills. Evaluations captured primarily self-reported reaction ( n  = 98, 61%) and learning outcomes ( n  = 83, 52%), with few assessing behaviors after active support ended ( n  = 37, 23%) or results ( n  = 45, 28%).

Conclusion

CBIs aiming to build implementation or QI capacity vary substantially in their development, evaluation, and reporting, making knowledge synthesis and reproducibility difficult. Greater emphasis on relational, emotional, and sustainability competencies may help participants develop a more balanced skill set. Strategies to create organizational conditions and rigorous longitudinal evaluations are required to support and assess CBIs' long-term impact and skill sustainability.

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