W5-T1 Introduction to Implementation

Question 1

the purpose of implementation science

Answer 1

take us from research to real-life settings and accelerate research into services

Question 2

example of how research evidence can be translated into clinical and national policy

Answer 2

through the use of the surgical checklist

1. found increasing need for surgery due to increasing societal pressure
2. WHO created the surgical checklist
3. complication and mortality decreased
4. became a national policy

Question 3

describe the surprise result found in Canada – the largest study of surgical checklist to date

Answer 3

the result of morbidity was essentially the same before and after the checklist introduced – the likely reason for the failure is that it was not actually used (Leape, 2014)

Question 4

what was lacking in the places where the checklist was not helpful

Answer 4

lack of well-thought-out implementation – staff was not consulted of the list, etc

Question 5

the need for science of implementation

Answer 5

to ensure something is introduced into clinical practise has a relationship with how it will then be used – the optimum result will be seen

Question 6

key finding from surgical checklist implementation study

Answer 6

– the way intervention is implemented vary greatly across organization and provider
– when introducing intervention – need to have a good implementation process and implemented the way it is intended to be used.

Question 7

define implementation science

Answer 7

the scientific study of methods to promote the uptake of research findings into routine healthcare in clinical, organisational, or policy context

– support innovative approaches to identify, understand, and overcome barriers to adopt, adapt, integrate, scale-up and sustainability of the evidence-based intervention, tools, policies and guidelines

Question 8

main difference between clinical and implementation studies

Answer 8

clinical
– aim to evaluate clinical intervention
– Intervene drug, procedure, therapy
– outcomes seen in symptoms health outcomes, mortality
– analyze and randomize patients and people

implementation
– aim to evaluate the implementation strategy
– Intervene clinician, organization practice change
– outcome in the form of adoption, adherence, fidelity
– analyse and randomise clinician, team facility

Question 9

overview of the scope and growth of the field globally

Answer 9

signs of growth:

UK national society established in 2017
several new scientific journals launched from 2019 onwards notably:
1. implementation science
2. UK implementation society

Question 10

implementation research terms

Answer 10

implementation strategies – methods/techniques used to magnify the adoption, implementation and sustainability of a clinical programme of intervention

implementation theories and frameworks – propose generalisable explanation regarding how intervention or programme implemented, whether successful or not

implementation context – factors or attributes that are external to an intervention or programme and that facilitate or impede implementation efforts

Question 11

risk of without studying and optimising implementation

Answer 11

improving patient care will remain slow at best

Question 12

aim of implementation study

Answer 12

to evaluate an implementation intervention which is called an implementation strategy

Question 13

implementation research examine

Answer 13

levels of adoption of an intervention
levels of fidelity to the design of the intervention