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Out-of-hospital cardiac arrest (OHCA) is a common, life-threatening event that is a leading cause of death in the United States. However, it is unclear how to design strategies that can be successfully implemented in emergency medical services (EMS) agencies and broader emergency response systems (such as fire, police, dispatch, and bystanders to OHCA events) in different communities to help improve daily care processes and outcomes in OHCA. The National Heart, Lung, and Blood Institute–funded Enhancing Prehospital Outcomes for Cardiac Arrest (EPOC) study lays the foundation for future quality improvement efforts in OHCA by identifying, understanding, and validating the best practices adopted within emergency response systems to address these life-threatening events and by addressing potential barriers to implementation of these practices. RAND researchers developed recommendations covering all levels of the prehospital OHCA incident response and the principles of change management necessary to implement those recommendations.

Additional file 2. Table A.1 Criteria1 for assigning quantitative ratings to CFIR constructs.

Additional file 1.

Additional file 1.

Additional file 1. COREQ checklist. PDF file COREQ (COnsolidated criteria for REporting Qualitative research) Checklist Items included in report and respective page numbers on which they appear

Supplemental material, sj-pdf-1-chi-10.1177_1742395320949633 for Caregiver role development in chronic disease: A qualitative study of informal caregiving for veterans with diabetes by Beth Fields, Lena Makaroun, Keri L Rodriguez, Claire Robinson, Jane Forman and Ann-Marie Rosland in Chronic Illness

Additional file 1. Completed COREQ Checklist.

Additional file 2. Table. Criteria for assigning quantitative ratings to CFIR constructs.

Interview Guide.docx. Contains interview guide used during data collection. (DOCX 21 kb)

ObjectiveThe Prevention of Hospital Infections by Intervention and Training (PROHIBIT) project included a cluster-randomised, stepped wedge, controlled study to evaluate multiple strategies to prevent catheter-related bloodstream infection. We report an in-depth investigation of the main barriers, facilitators and contextual factors relevant to successfully implementing these strategies in European acute care hospitals.MethodsQualitative comparative case study in 6 of the 14 European PROHIBIT hospitals. Data were collected through interviews with key stakeholders and ethnographic observations conducted during 2-day site visits, before and 1 year into the PROHIBIT intervention. Qualitative measures of implementation success included intervention fidelity, adaptation to local context and satisfaction with the intervention programme.ResultsThree meta-themes emerged related to implementation success: ‘implementation agendas’, ‘resources’ and ‘boundary-spanning’. Hospitals established unique implementation agendas that, while not always aligned with the project goals, shaped subsequent actions. Successful implementation required having sufficient human and material resources and dedicated change agents who helped make the intervention an institutional priority. The salary provided for a dedicated study nurse was a key facilitator. Personal commitment of influential individuals and boundary spanners helped overcome resource restrictions and intrainstitutional segregation.ConclusionThis qualitative study revealed patterns across cases that were associated with successful implementation. Consideration of the intervention–context relation was indispensable to understanding the observed outcomes.