Why is it so hard to implement change? A qualitative examination of barriers and facilitators to distribution of naloxone for overdose prevention in a safety net environment

The distribution of take home kits of naloxone, an opioid reversal drug, has been shown to be an effective and practical public health intervention to combat the large number of overdose deaths, an epidemic in the United States. However, when one safety net hospital emergency department attempted to increase naloxone kits availability to 24/7, the data showed no increases in take home naloxone kit expansion.  In this paper, authors sought to define facilitators and barriers of the implementation of this intervention using focus groups and interviews. Interestingly, despite strong philosophical support and knowledge of the intervention, logistical barriers such as protocol, work-flow, and staff perceptions and roles made this intervention difficult to implement on the floor.  Authors use PARiHS framework to analyze these facilitators and barriers and give suggestions for future implementation of interventions in hospital settings. Read more here