Adrenal Vein Sampling (AVS) is a complicated procedure requiring clinical expertise, collaboration, and patient involvement to ensure it occurs successfully. Implementation science offers unique insights into the barriers and enablers of service delivery — which are critical to the provision of quality healthcare. The primary aim of this scoping review was to identify implementation components as described within clinical studies, that contribute to a successful AVS procedure. The secondary aim was to provide informed considerations for practice to support the scale-up of AVS.
A scoping review was conducted for clinical papers that also discussed factors contributing to effective AVS implementation. Implementation strategies were named and defined, allowing for implementation learnings to be synthesised in the absence of dedicated research examining implementation processes.
Ten implementation components reported as contributing to a successful AVS procedure were identified. These components were categorised according to actions required pre-AVS (technical skills development, protocol standardisation, adrenal venous mapping and patient preparation), during AVS (procedural support, rapid cortisol assays and collaboration with pathology) and post-AVS (consensus based criteria and team based approach to AVS outcome interpretation). A taxonomy of strategies effective in implementing change was utilised to support and inform the development of recommendations for scale-up.
Using an implementation science approach, the findings of this review and analysis provide practical insights and considerations to facilitate AVS service delivery design. Extracting implementation science information from clinical research has provided a mechanism that accelerates the translation of evidence into practice where implementation research is not yet available. It represents an approach to inform future implementation research in a directed and focussed manner.