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Contextual factors influencing the implementation of the obstetrics hemorrhage initiative in Florida

Journal of Perinatology volume 37, pages 150–156 (2017)Cite this article

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Abstract

Objective:

The purpose of this study was to explore the multilevel contextual factors that influenced the implementation of the Obstetric Hemorrhage Initiative (OHI) among hospitals in Florida.

Study Design:

A qualitative evaluation was conducted via in-depth interviews with multidisciplinary hospital staff (n=50) across 12 hospitals. Interviews were guided by the Consolidated Framework for Implementation Research and analyzed in Atlas.ti using rigorous qualitative analysis procedures.

Result:

Factors influencing OHI implementation were present across process (leadership engagement; engaging people; planning; reflecting), inner setting (for example, knowledge/beliefs; resources; communication; culture) and outer setting (for example, cosmopolitanism) levels. Moreover, factors interacted across levels and were not mutually exclusive. Leadership and staff buy-in emerged as important components influencing OHI implementation across disciplines.

Conclusion:

Key contextual factors found to influence OHI implementation experiences can be useful in informing future quality improvement interventions given the institutional and provider-level behavioral changes needed to account for evolving the best practices in perinatology.

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Acknowledgements

This project was supported by funds from the Florida Department of Health. We thank all the hospitals and multidisciplinary staff members who participated in this study for their time and willingness to share their candid experiences implementing this quality-improvement initiative.

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Authors and Affiliations

  1. Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA

    C A Vamos, E L Thompson, A Cantor & W Sappenfield

  2. The Lawton and Rhea Chiles Center for Healthy Mothers and Babies, College of Public Health, University of South Florida, Tampa, FL, USA

    L Detman

  3. Florida Perinatal Quality Collaborative, The Lawton and Rhea Chiles Center for Healthy Mothers and Babies, College of Public Health, University of South Florida, Tampa, FL, USA

    L Detman, E Bronson & A Phelps

  4. Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA

    J M Louis

  5. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Florida, Gainesville, FL, USA

    A R Gregg

  6. University of South Florida Health, Morsani College of Medicine, University of South Florida, Tampa, FL, USA

    J S Curran

Authors
  1. C A Vamos
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  2. E L Thompson
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  3. A Cantor
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  6. A Phelps
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  7. J M Louis
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  8. A R Gregg
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  9. J S Curran
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  10. W Sappenfield
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Corresponding author

Correspondence to C A Vamos.

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The authors declare no conflict of interest.

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Cite this article

Vamos, C., Thompson, E., Cantor, A. et al. Contextual factors influencing the implementation of the obstetrics hemorrhage initiative in Florida. J Perinatol 37, 150–156 (2017). https://doi.org/10.1038/jp.2016.199

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