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As Lewis and colleagues6 highlight, mechanisms that drive changes in short term and overall outcomes must be explicitly described for others to feel confident in implementing the intervention themselves.
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However, using economic models to make individual decisions, whether that is for a single patient or a whole hospital, is fraught with difficulty. Efforts to link the economic results more tightly to mechanisms of action will help guide decision makers to decide whether replication is warranted.
This depends, in part, on whether they kamagra mg oral jelly amazon can expect similar results if they invest in similar interventions and implementation strategies.
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We hope kamagra mg oral jelly amazon there will be more economic evaluations of implementation efforts in the future. In that vein, we offer a few suggestions.
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First, jargon can be an impediment, especially in multidisciplinary areas such as implementation kamagra mg oral jelly amazon science. Readers with varying experience with either implementation science or economic evaluation often talk past each other due to a lack of mutual understanding over discipline-specific language.
Personnel ie, labour typically represents a variable cost because the cost varies by the scale of production. Ajmi and colleagues4 reported that kamagra mg oral jelly amazon the majority of costs were fixed and attributable to personnel, which may confuse some readers. It is possible that Ajmi and colleagues used the terms programme costs synonymously with fixed costs, but programme costs often vary at some level, and for interdisciplinary work, clearly explaining key terms will therefore pay dividends.
Second, to estimate the cost of the implementation strategies, most researchers rely on microcosting approaches that involve identifying the quantities kamagra mg oral jelly amazon of inputs used in the production of a service.
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In this study, the authors used staff surveys, with input from programme directors, to estimate the total cost. Microcosting approaches differ in precision kamagra mg oral jelly amazon and accuracy due to the timing and method of data collection.
As a field, we need to find more accurate kamagra mg oral jelly amazon ways to track staff effort.
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Periodic surveys asking staff to recall their effort in the past month may be feasible, but whether these estimates are accurate is unknown and untested. Building time tracking systems into the workflow is perhaps the best method to ensure accurate and precise time estimates. Finally, as noted above, studies should ideally shed light on the mechanisms of action.
For many implementation activities, time tracking systems can also inform the kinds of implementation efforts needed for future implementation planning purposes, whether those efforts kamagra mg oral jelly amazon are small and steady or rare but large. Creating tables of implementation costs, while helpful, provides only part of the information needed to make thoughtful decisions about implementation.
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