Methodological development for quantitative systematic reviews of effects has broad scientific consensus, however the same cannot be said across the field qualitative synthesis. In qualitative synthesis, the normative features ascribed to systematic reviews of quantitative data have been challenged, adopted, rejected, or transposed to different extents into analogous concepts and methods more attune to the nuances of the critical and interpretive research paradigms.
The purpose of this chapter is to provide the rationale, methodology and methods for meta aggregation as an approach to qualitative synthesis. Its developmental history is grounded in philosophic perspectives with the needs and expectations of evidence to inform health care decision-making. Meta aggregation is a method that mirrors the accepted conventions for systematic review whilst holding to the traditions and requirements of qualitative research (it aggregates findings in to a combined whole that is more than the sum of the individual findings in a way that is analogous with meta analysis). This section of the handbook provides an overview of the steps required when conducting a small (single unit or single site) or large-scale (multi-unit or multi-site) evidence implementation project across a health organization, informed by the JBI Implementation Framework (Figure 2). In essence, an evidence implementation project is a clinically oriented, team-based initiative toward implementing the best available evidence into an organization’s systems and processes of everyday care. These evidence implementation projects are quality-improvement initiatives utilizing a very similar approach to the Plan, Do, Study, Act cycle, with an emphasis on clinical leadership and evidence-based practice change. The JBI Implementation approach is firmly grounded in the audit, feedback and re-audit process and a structured approach to the identification and management of the barriers to change. This approach has been found to be successful in the JBI Clinical Fellowship Program, where more than 300 healthcare professionals have successfully implemented and changed practice following this framework (Bayuo, Munn & Campbell 2017; Craven et al. 2014; Mwita et al. 2013; Sykes 2012). Additionally, this framework has been used in large, multi-site studies (Harvey, Gill, Kitson & Munn 2012; Kurmis et al. 2015; Stephenson et al. 2015). The development of this framework has been informed by the experience of JBI while conducting evidence implementation projects for more than 20 years, in addition to the best available evidence regarding evidence implementation from reviews of models, theories and frameworks in the field of knowledge translation and implementation science (Milat & Li 2017; Nilsen, P 2015; Strifler et al. 2018; Tabak, RG et al. 2012).
Figure 2: JBI Implementation Framework
This section of this guide presents a “hands-on” overview of the practical requirements and considerations in setting up and running a successful evidence implementation project. This guide is designed to provide project teams with a comprehensive guide to conducting a JBI evidence implementation project.