Cover: Innovation Adoption, Use and Implementation in Emergency Departments During the COVID-19 Pandemic

Innovation Adoption, Use and Implementation in Emergency Departments During the COVID-19 Pandemic

Published in: BMJ Innovations (2024). DOI: 10.1136/bmjinnov-2023-001206

Posted on rand.org May 1, 2024

by Shreya S. Huilgol, Carl Berdahl, Nabeel Qureshi, Catherine C. Cohen, Peter Mendel, Shira H. Fischer

Introduction

During a public health emergency like the COVID-19 pandemic, emergency department (ED) clinicians may be able to save more lives if they rapidly identify and implement innovations that are safe and effective. However, there is little research examining clinician decision-making around innovation implementation during public health emergencies and when evidence-based information is limited.

Objective

The goals of this study were to understand how ED clinicians decided to implement innovations and to describe the facilitators and challenges they faced during implementation.

Methods

We conducted 3 pilot interviews and 13 focus group discussions with clinicians from eight hospital-based EDs across the USA. Seventeen physicians, seven advanced practice providers, 18 nurses and seven respiratory therapists participated. We used inductive and deductive techniques to perform content and thematic analysis of focus group transcripts.

Results

Participants cited social media, clinician autonomy, limited resources, organisational culture, supportive leadership and outside experiences as facilitators of trying innovations. Challenges in trying new innovations included limited evidence-based information, evolving guidelines, fear, moral distress and clinician pushback. Facilitators of using innovations in practice included leadership advocating for continued use, signs of patient improvement, ease of adoption and adequate resources. Challenges were the lack of familiarity, no established protocol and limited information dissemination about best practices.

Conclusion

Our study highlights factors that influenced innovation adoption and implementation in EDs during the COVID-19 pandemic, including how fear and moral distress affected decision-making. Organisations can support the implementation of promising innovations by selecting strong leaders, ensuring clinician psychological safety, providing protocols and resources and highlighting successes.

Research conducted by

This report is part of the RAND external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.