Week 5: Introduction to Implementation Science

Question 1

A nerve cell that transmits electrical and chemical signals throughout the brain and nervous system.

Answer 1

Neuron

Question 2

The junction between two neurons where communication takes place.

Answer 2

Synapse

Question 3

The largest part of the brain, responsible for higher-order functions like thought, emotion, and movement.

Answer 3

Cerebrum

Question 4

A chemical substance released by a neuron that travels across the synapse to influence another neuron.

Answer 4

Neurotransmitter

Question 5

A type of cell in the nervous system that provides support and protection for neurons.

Answer 5

Glial Cells

Question 6

It is divided into lobes: frontal, parietal, temporal, and occipital.

Answer 6

Cerebrum

Question 7

Located at the back of the brain, it coordinates movement and balance.

Answer 7

Cerebellum

Question 7

It connects the brain to the spinal cord and regulates vital functions like breathing and heart rate.

Answer 7

Brainstem

Question 8

The outermost layer of the cerebrum, responsible for higher-order functions like thought, perception, and voluntary movement.

Answer 8

Cortex

Question 9

A region of the frontal lobe that controls voluntary movements.

Answer 9

Motor Cortex

Question 10

A long, bundled structure that connects the brain to the rest of the body, transmitting sensory and motor signals.

Answer 10

Spinal Cord

Question 10

The frontmost part of the frontal lobe, involved in planning, decision-making, and personality.

Answer 10

Prefrontal Cortex

Question 11

Located at the front of the brain, involved in higher cognitive functions, personality, and voluntary movement.

Answer 11

Frontal Lobe

Question 12

Located behind the frontal lobe, involved in sensory processing, spatial awareness, and attention.

Answer 12

Parietal Lobe

Question 13

Located on the sides of the brain, involved in auditory processing, memory formation, and emotion.

Answer 13

Temporal Lobe

Question 14

Located at the back of the brain, primarily responsible for visual processing.

Answer 14

Occipital Lobe

Question 15

A simple yet effective tool designed to improve the safety of surgical procedures.

Aims to reduce the risk of surgical complications and improve patient outcomes.

Is completed at three key points during the surgical procedure: before anesthesia, during surgery, and after surgery.

Answer 15

WHO Surgical Safety Checklist

Question 15

It is a field that focuses on the study of methods to promote the adoption and use of evidence-based interventions in routine practice.

It has an increasing emphasis on improving healthcare quality and outcomes.

Answer 15

Implementation Science

Question 16

Implementation studies differ from clinical studies in their focus on the process of implementing interventions rather than just evaluating their effectiveness.

Answer 16

Implementation Science VS Clinical Studies

Question 17

Refers to the incidence of disease or illness within a population. It is a measure of the frequency of a disease or condition.

Answer 17

Morbidity

Question 18

Refers to the incidence of death within a population. It is a measure of the number of deaths from a particular cause.

Answer 18

Mortality

Question 19

Challenge in Implementation Science

Answer 19

It is not enough to have a good implementation process - compliance, training, and follow through is necessary to ensure implementation is done as intended.

Question 20

Studies suggest that it can take this average number of years for new evidence to be translated into clinical practice.

Answer 20

17 years

Question 21

What is the Research-Practice Gap?

Answer 21

Studies suggest that it can take an average of 17 years for new evidence to be translated into clinical practice.

This delay in implementation can lead to suboptimal care for patients.

Research: Prioritizes innovation, controlled conditions, and selective participants.
Clinical Practice: Focuses on sustainability, generalizability, and resource constraints.

Question 22

Research and Development Process in Clinical Practice

Answer 22

1) Generating evidence from research
2) Synthesizing the evidence
3) Developing evidence-based clinical policies
4) Applying the policies

Question 22

Considerations in Making Clinical Decisions for Patient Care

Answer 22

• The patient’s circumstances
• The evidence
• The patient’s wishes

Question 23

Challenges to Bridging the Research-Practice Gap

Answer 23

Selection Bias: Research studies often involve highly selected participants and settings, leading to limited generalizability to real-world practice.

Implementation Costs: Implementing new interventions can be expensive, requiring resources for training and adaptation.

Competing Priorities: Clinicians may be reluctant to adopt new practices if they perceive them as time-consuming or disruptive to existing workflows.

Question 24

What are the priorities of the research world?

Answer 24

• Maximizing efficacy of interventions
• Controlled conditions and selective participants
• High quality evaluations and trials
• Research funds
• Innovation and new approaches
• Selective staff
• Focus on specific interventions

Question 25

What are the priorities of Clinical Practice/Health Services?

Answer 25

• Achieve sustainable delivery
• Generalizability to a broad patient population
• Widespread adoption of interventions
• Reliability and consistency of care
• Resource constraints and financial limitations
• Diverse and generalist workforcce
• Focus on overall service delivery

Question 26

The scientific study of methods to promote the update of research findings into routine healthcare in clinical, organizational or policy contexts.

Answer 26

Implementation Science

Question 27

It supports innovative approaches to identifying, understanding, and overcoming barriers to the adoption, adaptation, integration, scale-up and sustainability of evidence-based interventions, tools, policies, and guidelines.

Answer 27

Implementation Science

Question 27

The continuum starts with basic research and progresses to clinical application.

Answer 27

Translational Continuum

Question 28

Implementation research within the Translational Continuum

Answer 28

1) Proof of Concept: Is it safe? Does it work?
2) Proof of Implementation: How does it work in real-world settings?
3) Informing Scale-up: Health systems integration and sustainability

Question 29

An early safety studies, where you don’t really think about implementation because you have no idea whether a new drug, a new therapy, or a new pathway will actually work at all.

Answer 29

Proof of Concept Studies

Question 30

Focus: Primarily interested in patient-reported outcomes and the effectiveness of clinical interventions (drugs, surgical techniques, therapies).

Unit of Analysis: Patients or groups of patients (may include facilities in cluster trials).

Outcomes: Patient symptoms, health outcomes (mortality, infection rates).

Answer 30

Clinical Effectiveness Research

Question 31

Focus: Primarily interested in provider-reported outcomes and the effectiveness of implementation strategies (methods to promote adoption and use of interventions).

Intervention: Implementation strategies, not clinical interventions.

Unit of Analysis: Providers, clinicians, clinical teams, or facilities.

Outcomes: Acceptability, feasibility, fidelity of implementation (delivered as designed), adoption rates.

Answer 31

Implementation Research

Question 32

Clinical Effectiveness Research VS Implementation Research

Answer 32

Implementation research focuses on the “how” of implementing interventions, while clinical research focuses on the “what” (effectiveness of interventions).

Question 33

Research that investigates the safety, efficacy, and effectiveness of clinical interventions.

Answer 33

Clinical Research

Question 34

A medical treatment or procedure designed to improve a patient’s health or treat a disease.

Examples: drugs, surgical techniques, and psychological therapies

Answer 34

Clinical Intervention

Question 35

The main measure of success or failure in a clinical research study. It can be a patient-reported outcome (e.g., symptoms, quality of life) or a health outcome (e.g., mortality, infection rates).

Answer 35

Primary Outcome

Question 36

The level at which data is collected and analyzed in a research study. It can be individual patients, groups of patients, or facilities.

Answer 36

Unit of Analysis

Question 36

A process of assigning participants to different groups (experimental or control) by chance to ensure that the groups are comparable at the start of a study.

Answer 36

Randomization

Question 37

A method or approach used to promote the adoption and use of clinical intervention in routine practice.

Answer 37

Implementation Strategy

Question 38

Data collected from healthcare providers about their experiences with implementing an intervention.

Answer 38

Provider-Reported Outcomes

Question 39

The practicality or ease of implementing an intervention in a clinical setting.

Answer 39

Feasibility

Question 39

The perceived value or usefulness of an intervention by healthcare providers.

Answer 39

Acceptability

Question 40

Methods or techniques used to enhance the adoption, implementation, and sustainability of a clinical program or intervention.

Answer 40

Implementation Strategies

Question 40

The extent to which an intervention is delivered as intended, following the guidelines and protocols.

Answer 40

Fidelity

Question 41

Proposed generalizable explanations regarding how interventions or programs are implemented; whether implementation is successful, and why.

Answer 41

Implementation Theories and Frameworks

Question 42

Factors or attributes that are external to an intervention or program and that facilitate or impede implementation efforts.

Answer 42

Implementation Context