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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 subcategory



Organisational culture

Strategies to change organisational culture

Multidisciplinary teams, steering committees, regular briefings, leadership/leaders’ involvement

Audit and feedback

A 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 action

Feedback sessions, personal performance feedback, posting SSI or compliance rates

Clinical incident reporting

System for reporting critical incidents

Critical Incident Reporting Systems

Monitoring the performance of the delivery of healthcare

Monitoring of health services by individuals or healthcare organisations, for example by comparing with an external standard

Monitoring compliance with SSI preventive measures, monitoring SSI incidence

Communities of practice

Groups of people with a common interest who deepen their knowledge and expertise in this area by interacting on an ongoing basis

Regional hospital collaboration to regularly exchange knowledge and improve quality

Continuous quality improvement

An 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 changes

Regular meetings to review compliance with preventive measures and when necessary to eliminate barriers to improve quality of care

Educational games

The use of games as an educational strategy to improve standards of care

Video games, smartphone-based games, quizzes

Educational materials

Distribution 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 formulation

Posters, newsletters, bulletins

Educational meetings

Courses, workshops, conferences or other educational meetings

Educational sessions, educational lectures, grand round lectures, workshops

Educational outreach visits, or academic detailing

Personal visits by a trained person to health workers in their own settings, to provide information with the aim of changing practice

Site visits by a trained healthcare professional to educate groups or individuals

Clinical Practice Guidelines

Clinical 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 education

Continuing education for health professionals that involves more than one profession in joint, interactive learning

Interdisciplinary education

Local consensus processes

Formal 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 guidelines

Clinical practice guideline development with agreeing from all levels

Local opinion leaders

The identification and use of identifiable local opinion leaders to promote good clinical practice

Involvement of project officers, study champions

Managerial supervision

Routine supervision visits by health staff

Supervision by managerial staff

Patient-mediated interventions

Any intervention aimed at changing the performance of healthcare professionals through interactions with patients, or information provided by or to patients

Patient feedback, patients as committee members

Public release of performance data

Informing the public about healthcare providers by the release of performance data in written or electronic form.

Publicly accessible websites that provide performance reports


Manual or computerised interventions that prompt health workers to perform an action during a consultation with a patient, for example computer decision support systems

Checklists, automatic electronic reminders, protocols

Routine patient-reported outcome measures

Routine administration and reporting of patient-reported outcome measures to providers and/or patients

Assessing patients’ experience of symptoms through questionnaires before and after interventions

Tailored interventions

Interventions to change practice that are selected based on an assessment of barriers to change, for example through interviews or surveys

Developing implementation interventions based on previously identified barriers

  1. a Note: This column shows the original definitions as presented in [26]