Adaptive design: adaptation and adoption of patient safety practices in daily routines, a multi-site study.

This study explored whether combining participatory design and experiential learning supports the adaptation and adoption of TOPplus, which is a communication tool to support and improve communication and teamwork among the operating room team. Adaptation varied amongst the ten participating Dutch hospitals, but all implemented the intervention with all surgical disciplines, and this approach gave teams the opportunity to adapt the intervention to fit their needs and local context.