Implementation Science

IS: What is it?

Implementation is about taking something designed elsewhere and making it work in a certain setting. There is growing recognition that strong interventions often fail without careful consideration about:

  • how to introduce that intervention to a setting,
  • build excitement and buy-in for it,
  • put systems in place that support it,
  • how it is going to be paid for over time
  • and how to measure how well it is being delivered.

This science about these things is implementation science. It is closely related to quality science -- the process of monitoring for quality and fixing things when they go awry -- and the science of dissemination, methods on how to spread good interventions to the places they need to go.

Implementation is about strategy. Here is an article that is a compilation of implementation strategies that some of you will be able to access. Among these strategies are:

Planning Strategies. You should be thoughtful about who is going to be consulted and involved in rolling out the intervention, who needs to be motivated and how, who is going to manage the project, how it is going to be rolled out.

Education Strategies. This is mostly about creating training that will stick, with appealing packaging, booster sessions, training for supervisors and other stakeholders, coaching and consultation.

Finance Strategies. If you want something to work, it is best to think about something is going to be reimbursed or pay for itself before you roll it out.

Restructuring Strategies. Take a hard look at what you've got and see whether you have the right people, the right skills and the right space to implement this new thing well. If not, you may need to hire new people, reconfigure teams or reconfigure space.

Quality Management Strategies. These include monitoring for quality (adherence to the model, competence, outcomes) and feeding that information back to the right people in ways that motivate good work. It is also about recognizing when things have gone awry and knowing how to fix things once broken. See the quality improvement page.

Policy Strategies. Smart players know that they can alter the policy landscape to favor strong implementation.

Resources for learning implementation.

Here is a powerpoint on implementation science by Bryan Weiner from the 2011 Training Institute on Dissemination and Implementation Research in Health. You can find a host of presentations from this training institute here.

Here is a powerpoint of an introductory talk I (c.m.) gave recently on implementation science.

The National Implementation Research Network has  a nice "learn implementation" web page.

Here is a book on Dissemination and Implementation Research in Health. There is a chapter in it on implementation and dissemination in the social services that I (c.m.) wrote.D & I  in Health

 

 

 

 

The journal Implementation Science provides free online access to all of its articles. It is pretty academic-ish, but also pretty darn awesome for a free online journal.logo-1

Blog posts on implementation Science

If healthcare isn’t getting better, do we stand a chance in the social services?

The current issue of Quality and Safety in Healthcare contains an incisive editorial by Kaveh Shojania and Eric Thomas about why the QI field has not been able to demonstrate widespread improvements in patient safety as a result of their efforts. … Continue reading