Implementation of OR in healthcare services

Abstract

Previous studies suggest that less than 10% of healthcare OR articles mention the implementation of results. Taking a ‘positive deviance’ approach, we reviewed studies that do mention the implementation of OR in health services to better understand ‘what works’. We searched Web of Knowledge, Scopus, and PubMed for articles. We screened 4,992 studies and included 163. All of the included articles described, at a minimum, a decision to implement change. 121 (74%) described implemented changes, of which 91 (56%) provided some elements of evaluation (mostly before-after comparisons). 134 (82%) described stakeholder engagement. 57 (35%) mentioned implementation in two-three sentences, 82 (50%) in one paragraph to one section, and in 24 (15%) implementation was a key aspect. In these 24 articles, some influencing factors were recurring (e.g., client commitment, perceived usefulness of the intervention), while others were barely mentioned (e.g., time and cost of implementation). No paper referred to an implementation science framework, but some referred to Soft OR or improvement science as implementation strategies. The number of studies we identified is encouraging, but inconsistent reporting is an issue. Deeper engagement within the OR field and interdisciplinary collaboration with implementation and/or improvement science may help support sustained adoption and long-term impact.