ImplementingResearchintoPractice

VickyScott,RN,PhDClinicalProfessor,FacultyofMedicine,SchoolofPopulationandPublicHealth,UniversityofBritish

Columbia

ImplementationScienceImplementationScience:isthescientificstudyofvariablesand

conditionsthatimpactchangesatpractice,organizationandsystemslevels;changesthatarerequiredtopromotethesystematicuptake,sustainabilityandeffectiveness ofevidence-basedprogramsandpracticesintypicalserviceandsocialsettings.(BlaseandFixsen,2010,NIRN )

Thegoalofthispresentation istohelpyoutoincorporateinterventionstoreduceinjuriesintoyourorganizationsinawaythatisbotheffectiveandsustainable

InterventionsAloneNotEnough

Whyevidenceisnotenough

FindingsfromtheNationalImplementationResearchNetworkrevealfourmainreasonswhyprovenevidence-basedinterventionsdonotproduceresultsasintended:

1. Whatisknownisnotwhatisadopted2. Whatisadoptedisnotusedwithfidelity3. Whatisadoptedisnotsustainedforlongenough4. Whatisadoptedisnotusedonascalethatwouldhavea

broadimpact

Practitionersdonotuse“experimentalrigor”,theyuse

programs.

OperationalizationResearchersandimplementersworkingtogetherto:

– Defineinterventioncoreelements– Defineprinciplesandvaluesthatunderpintheintervention(e.g.,autonomyofrecipients)

– Defineintendedpopulation– Supportallimplementationstages– Understandtheimplementationcontext

NEED

CAPACITY FIT

READINESS RESOURCES

EVIDENCE

ImplementationContext

http://implementation.fpg.unc.edu

1.Need

• Dataindicatingneed• Significanceoftheissue• Perceptionofneedbystaffandrecipients

2.FitwithCurrentPractice

• Alignswithorganization’spriorities• Compatiblewithorganizationstructures,policiesandpractices

• Compatiblewithcommunityvaluesandbeliefs

3.Resources

• Administrationsupport• Physicalsetting• Technologyanddatasupports

• Implementationexpertise• Staffingandsupervisors• Trainingandcoaches

Training example: Canadian Falls Prevention Curriculum

To increase knowledge among health care providers and community leaders on how to:

• design, • implement and • evaluate

an evidence-based, multi-sectorial fall prevention program for older adults.

www.canadianfallprevention.ca

4.Evidence

• Outcome– isitworthit?• Fidelityofdata• Populationsimilarities,e.g.,age,healthandculture

• Costeffectiveness• Efficacyoreffectiveness• Number/qualityofstudies

5.Readiness• Experttrainers• Qualificationsofimplementersandevaluators• Maturesitetoobserve• Operationaldefinitionsofcorefunctions• Usabilitypilot(Plan,Do,Study,Act)

Act Plan

DoStudy

PDSACycle

Act Plan

DoStudy

Trialandlearntoidentifycorecomponentsandactiveingredientstofurtherevaluate,improveanddiscardnon-essentialcomponents.

Doinpartnershipwithresearchers,programdevelopersandearlyimplementers.

Usability Pilot

6.Capacity• Buy-inprocessoperationalized

– Practitioners– Recipientsofinterventions

• Sustainability– Staffcompetencies– Organizationdatasupport– Leadershipadaptability– Financialandtechnicalsupport

• Continuousqualityimprovementsupportedbyshared learning andauditsofcompetency

CompetencyDrivers

• Selection:ofstaffwiththerequiredknowledge,basicskillsandabilities

• Training:ofstaffonnewskillsandpracticesandwhen,howandwithwhomtheywillbeused

• Coaching:ofstafftooverseethepracticeandmasteringofnewskillsonthejob.Performanceassessmentsarekey.

NEED

CAPACITY FIT

READINESS RESOURCES

EVIDENCE

ScoringYourReadinessHigh=5

Med=3

Low=1

1.Need

2.Fit

3.Resources

4.Evidence

5.Readiness

6.Capacity

TotalScore

http://implementation.fpg.unc.edu

Thankyou!Kiitos toourFinnishhostsforinviting

ustotheirbeautifulcountry!