Moving medical evidence into practice: Implementation Science - many studies

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Implementation science: What is it and why should I care? – Jan 2020

Psychiatry Research Volume 283, https://doi.org/10.1016/j.psychres.2019.04.025  PDF
Mark S.Bauer ab JoAnn Kirchner bc

Highlights

• Establishing effectiveness of an innovation does not guarantee its uptake into routine usage.
• Innovation uptake depends largely on contextual factors, not just innovation effectiveness.
• Implementation science addresses such contextual barriers and facilitators to enhance innovation uptake.

Centuries of experience make it clear that establishing the effectiveness of a clinical innovation is not sufficient to guarantee its uptake into routine use. The relatively new field of implementation science has developed to enhance the uptake of evidence-based practices and thereby increase their public health impact.

Implementation science shares many characteristics, and the rigorous approach, of clinical research. However, it is distinct in that it attends to factors in addition to the effectiveness of the clinical innovation itself, to include identifying and addressing barriers and facilitators to the uptake of evidence-based clinical innovations.

This article reviews the definition, history, and scope of implementation science, and places the field within the broader enterprise of biomedical research. It also provides an overview of this Special Issue of Psychiatry Research, which introduces the principles and methods of implementation science to mental health researchers.

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An introduction to implementation science for the non-specialist - 2015

BMC Psychology volume 3, Article number: 32 (2015) PDF
Mark S. Bauer, Laura Damschroder, Hildi Hagedorn, Jeffrey Smith & Amy M. Kilbourne

Background
The movement of evidence-based practices (EBPs) into routine clinical usage is not spontaneous, but requires focused efforts. The field of implementation science has developed to facilitate the spread of EBPs, including both psychosocial and medical interventions for mental and physical health concerns.

Discussion
The authors aim to introduce implementation science principles to non-specialist investigators, administrators, and policymakers seeking to become familiar with this emerging field. This introduction is based on published literature and the authors’ experience as researchers in the field, as well as extensive service as implementation science grant reviewers.

Implementation science is “the scientific study of methods to promote the systematic uptake of research findings and other EBPs into routine practice, and, hence, to improve the quality and effectiveness of health services.” Implementation science is distinct from, but shares characteristics with, both quality improvement and dissemination methods. Implementation studies can be either assess naturalistic variability or measure change in response to planned intervention. Implementation studies typically employ mixed quantitative-qualitative designs, identifying factors that impact uptake across multiple levels, including patient, provider, clinic, facility, organization, and often the broader community and policy environment. Accordingly, implementation science requires a solid grounding in theory and the involvement of trans-disciplinary research teams.

Summary
The business case for implementation science is clear: As healthcare systems work under increasingly dynamic and resource-constrained conditions, evidence-based strategies are essential in order to ensure that research investments maximize healthcare value and improve public health. Implementation science plays a critical role in supporting these efforts.

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Closing the health equity gap: A role for implementation science? – Sept 2021

PLOS https://doi.org/10.1371/journal.pmed.1003762  PDF

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The Coming of Age of Implementation Science and Research in Critical Care Medicine – Aug 2021

Crit Care Med. 2021 Aug 1; 49(8): 1254–1275. doi: 10.1097/CCM.0000000000005131 PDF

Juliana Barr, MD, FCCM,1,2 Shirley S. Paulson, DNP, MPA, RN, NEA-BC,3 Biren Kamdar, MD, MBA, MHS,4 Jennifer N. Ervin, PhD,5 Meghan Lane-Fall, MD, MSHP, FCCM,6,7 Vincent Liu, MD, MS,8,9,10,11 and Ruth Kleinpell, PhD, RN, FCCM12

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Too much theory and not enough practice? The challenge of implementation science application in healthcare practice – July 2021 _NO PDF

Journal of Evaluation in Clinical Practice https://doi.org/10.1111/jep.13600 PDF is behind a paywall
Frances Rapport PhD,James Smith PhD,Karen Hutchinson PhD,Robyn Clay-Williams PhD,Kate Churruca PhD,Mia Bierbaum Master Public Health,Jeffrey Braithwaite PhD

Background
Implementation science (IS) should contribute to maintaining high standards of care across healthcare systems and enhancing care practices. However, despite the evident need for greater and more rapid uptake and integration of evidence in practice, IS design and methodology fall short of the needs of effective translation.

Aim
In this paper we examine what it is about IS that makes it so appealing for effective uptake of interventions in routine practice, and yet so difficult to achieve. We propose a number of ways that implementation scientists could build mutual relationships with healthcare practitioners and other stakeholders including public members to ensure greater shared care practices, and highlight the value of IS training, collaborative educational events, and co-designed research.

Discussion
More consideration should be given to IS applications in healthcare contexts. Implementation scientists can make a valuable contribution by mobilizing theory and improving practice. However, goals for an evidence-based system may be more appropriately achieved through greater outreach and collaboration, with methods that are flexible to support rapid implementation in complex adaptive systems. Collective learning and mutual trust can be cultivated by embedding researchers into healthcare services while offering greater opportunities for practitioners to learn about, and engage in, implementation research.

Conclusion
To bridge the worlds of healthcare practice and IS, researchers could be more consistent in the relationships they build with professionals and the public, communicating through a shared language and co-joining practical approaches to effective implementation. This will build capacity for improved collaboration and foster respectful, interdisciplinary relationships.

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Implementation Science: Application of Evidence-Based Practice Models to Improve Healthcare Quality – Mach 2021 - NO PDF

https://doi.org/10.1111/wvn.12495 PDF is behind a paywall
Sharon Tucker PhD, APRN-CNS, PMHCNS-BC, NC-BC, FNAP, FAAN,Molly McNett PhD, RN, CNRN, FNCS, FAAN,Bernadette Mazurek Melnyk PhD, APRN-CNP, FAANP, FNAP, FAAN … See all authors

Background
Translating research into practice is complex for clinicians, yet essential for high quality patient care. The field of implementation science evolved to address this gap by developing theoretical approaches to guide adoption and sustained implementation of practice changes. Clinicians commonly lack knowledge, time, and resources of how evidence-based practice (EBP) models can guide implementation, contributing to the knowledge-to-practice gap.

Aim
This paper aimed to equip clinicians and other healthcare professionals with implementation science knowledge, confidence, and models to facilitate EBP change in their local setting and ultimately improve healthcare quality, safety, and population health outcomes.

Methods
The field of implementation science is introduced, followed by application of three select models. Models are applied to a clinical scenario to emphasize contextual factors, process, implementation strategies, and outcome evaluation. Key attributes, strengths, opportunities, and utilities of each model are presented, along with general resources for selecting and using published criteria to best fit clinical needs. Partnerships between implementation scientists and clinicians are highlighted to facilitate the uptake of evidence into practice.

Linking Evidence to Action
Knowledge of implementation science can help clinicians adopt high-quality evidence into their practices. Application-oriented approaches can guide clinicians through the EBP processes. Clinicians can partner with researchers in advancing implementation science to continue to accelerate the adoption of evidence and reduce the knowledge-to-action gap.

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Moving from Implementation Science to Implementation Practice: The Need to Solve Practical Problems to Improve Behavioral Health Services - Aug 2021 NO PDF, 53 references

J. of Behavioral Health Services & Research V49, pages106–116 (2022) https://doi.org/10.1007/s11414-021-09765-1
Enya B. Vroom Ph.D., M.S. & Oliver T. Massey Ph.D.

It is well recognized that the use of evidence-based practices (EBPs) is critical to improving service outcomes for those receiving behavioral health services. However, EBPs are not easily implemented in behavioral health settings, and there are many challenges to supporting these services over time. Recently, research efforts in implementation science (IS) have greatly expanded our understanding of issues that influence the successful implementation of EBPs. Unfortunately, less effort has been devoted to translating this research theory on a practical level to help individual service entities solve the specific problems of putting programs into place. A process is needed where service organizations and practitioners can build their capacity, informed by IS research, to improve service outcomes. The purpose of this commentary is to describe the IS research base, provide an introduction to implementation practice, describe challenges confronting practitioners, and propose necessary steps in building organizational capacity that enables practitioners to implement the most effective services available.

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Vitamin D Life belives it is easier to go from bottom-up rather than top-down

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