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Table 1 EPOC implementation subcategories and definitions [26] with examples

From: Implementation interventions in preventing surgical site infections in abdominal surgery: a systematic review

EPOC implementation subcategoryDefinitionaExamples
Organisational cultureStrategies to change organisational cultureMultidisciplinary teams, steering committees, regular briefings, leadership/leaders’ involvement
Audit and feedbackA summary of health workers’ performance over a specified period of time, given to them in a written, electronic or verbal format. The summary may include recommendations for clinical actionFeedback sessions, personal performance feedback, posting SSI or compliance rates
Clinical incident reportingSystem for reporting critical incidentsCritical Incident Reporting Systems
Monitoring the performance of the delivery of healthcareMonitoring of health services by individuals or healthcare organisations, for example by comparing with an external standardMonitoring compliance with SSI preventive measures, monitoring SSI incidence
Communities of practiceGroups of people with a common interest who deepen their knowledge and expertise in this area by interacting on an ongoing basisRegional hospital collaboration to regularly exchange knowledge and improve quality
Continuous quality improvementAn iterative process to review and improve care that includes involvement of healthcare teams, analysis of a process or system, a structured process improvement method or problem solving approach, and use of data analysis to assess changesRegular meetings to review compliance with preventive measures and when necessary to eliminate barriers to improve quality of care
Educational gamesThe use of games as an educational strategy to improve standards of careVideo games, smartphone-based games, quizzes
Educational materialsDistribution to individuals, or groups, of educational materials to support clinical care, i.e., any intervention in which knowledge is distributed. For example this may be facilitated by the internet, learning critical appraisal skills; skills for electronic retrieval of information, diagnostic formulation; question formulationPosters, newsletters, bulletins
Educational meetingsCourses, workshops, conferences or other educational meetingsEducational sessions, educational lectures, grand round lectures, workshops
Educational outreach visits, or academic detailingPersonal visits by a trained person to health workers in their own settings, to provide information with the aim of changing practiceSite visits by a trained healthcare professional to educate groups or individuals
Clinical Practice GuidelinesClinical guidelines are systematically developed statements to assist healthcare providers and patients to decide on appropriate health care for specific clinical circumstances’(US IOM)Developing a new clinical practice guideline, choosing evidence-based guidelines
Inter-professional educationContinuing education for health professionals that involves more than one profession in joint, interactive learningInterdisciplinary education
Local consensus processesFormal or informal local consensus processes, for example agreeing a clinical protocol to manage a patient group, adapting a guideline for a local health system or promoting the implementation of guidelinesClinical practice guideline development with agreeing from all levels
Local opinion leadersThe identification and use of identifiable local opinion leaders to promote good clinical practiceInvolvement of project officers, study champions
Managerial supervisionRoutine supervision visits by health staffSupervision by managerial staff
Patient-mediated interventionsAny intervention aimed at changing the performance of healthcare professionals through interactions with patients, or information provided by or to patientsPatient feedback, patients as committee members
Public release of performance dataInforming the public about healthcare providers by the release of performance data in written or electronic form.Publicly accessible websites that provide performance reports
RemindersManual or computerised interventions that prompt health workers to perform an action during a consultation with a patient, for example computer decision support systemsChecklists, automatic electronic reminders, protocols
Routine patient-reported outcome measuresRoutine administration and reporting of patient-reported outcome measures to providers and/or patientsAssessing patients’ experience of symptoms through questionnaires before and after interventions
Tailored interventionsInterventions to change practice that are selected based on an assessment of barriers to change, for example through interviews or surveysDeveloping implementation interventions based on previously identified barriers
  1. a Note: This column shows the original definitions as presented in [26]