Week 5: Introduction to Implementation Science Flashcards
A nerve cell that transmits electrical and chemical signals throughout the brain and nervous system.
Neuron
The junction between two neurons where communication takes place.
Synapse
The largest part of the brain, responsible for higher-order functions like thought, emotion, and movement.
Cerebrum
A chemical substance released by a neuron that travels across the synapse to influence another neuron.
Neurotransmitter
A type of cell in the nervous system that provides support and protection for neurons.
Glial Cells
It is divided into lobes: frontal, parietal, temporal, and occipital.
Cerebrum
Located at the back of the brain, it coordinates movement and balance.
Cerebellum
It connects the brain to the spinal cord and regulates vital functions like breathing and heart rate.
Brainstem
The outermost layer of the cerebrum, responsible for higher-order functions like thought, perception, and voluntary movement.
Cortex
A region of the frontal lobe that controls voluntary movements.
Motor Cortex
A long, bundled structure that connects the brain to the rest of the body, transmitting sensory and motor signals.
Spinal Cord
The frontmost part of the frontal lobe, involved in planning, decision-making, and personality.
Prefrontal Cortex
Located at the front of the brain, involved in higher cognitive functions, personality, and voluntary movement.
Frontal Lobe
Located behind the frontal lobe, involved in sensory processing, spatial awareness, and attention.
Parietal Lobe
Located on the sides of the brain, involved in auditory processing, memory formation, and emotion.
Temporal Lobe
Located at the back of the brain, primarily responsible for visual processing.
Occipital Lobe
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.
WHO Surgical Safety Checklist
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.
Implementation Science
Implementation studies differ from clinical studies in their focus on the process of implementing interventions rather than just evaluating their effectiveness.
Implementation Science VS Clinical Studies
Refers to the incidence of disease or illness within a population. It is a measure of the frequency of a disease or condition.
Morbidity
Refers to the incidence of death within a population. It is a measure of the number of deaths from a particular cause.
Mortality
Challenge in Implementation Science
It is not enough to have a good implementation process - compliance, training, and follow through is necessary to ensure implementation is done as intended.
Studies suggest that it can take this average number of years for new evidence to be translated into clinical practice.
17 years
What is the Research-Practice Gap?
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.
Research and Development Process in Clinical Practice
1) Generating evidence from research
2) Synthesizing the evidence
3) Developing evidence-based clinical policies
4) Applying the policies
Considerations in Making Clinical Decisions for Patient Care
- The patient’s circumstances
- The evidence
- The patient’s wishes
Challenges to Bridging the Research-Practice Gap
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.
What are the priorities of the research world?
- 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
What are the priorities of Clinical Practice/Health Services?
- 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
The scientific study of methods to promote the update of research findings into routine healthcare in clinical, organizational or policy contexts.
Implementation Science
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.
Implementation Science
The continuum starts with basic research and progresses to clinical application.
Translational Continuum
Implementation research within the Translational Continuum
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
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.
Proof of Concept Studies
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).
Clinical Effectiveness Research
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.
Implementation Research
Clinical Effectiveness Research VS Implementation Research
Implementation research focuses on the “how” of implementing interventions, while clinical research focuses on the “what” (effectiveness of interventions).
Research that investigates the safety, efficacy, and effectiveness of clinical interventions.
Clinical Research
A medical treatment or procedure designed to improve a patient’s health or treat a disease.
Examples: drugs, surgical techniques, and psychological therapies
Clinical Intervention
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).
Primary Outcome
The level at which data is collected and analyzed in a research study. It can be individual patients, groups of patients, or facilities.
Unit of Analysis
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.
Randomization
A method or approach used to promote the adoption and use of clinical intervention in routine practice.
Implementation Strategy
Data collected from healthcare providers about their experiences with implementing an intervention.
Provider-Reported Outcomes
The practicality or ease of implementing an intervention in a clinical setting.
Feasibility
The perceived value or usefulness of an intervention by healthcare providers.
Acceptability
Methods or techniques used to enhance the adoption, implementation, and sustainability of a clinical program or intervention.
Implementation Strategies
The extent to which an intervention is delivered as intended, following the guidelines and protocols.
Fidelity
Proposed generalizable explanations regarding how interventions or programs are implemented; whether implementation is successful, and why.
Implementation Theories and Frameworks
Factors or attributes that are external to an intervention or program and that facilitate or impede implementation efforts.
Implementation Context
