Vicky Scott: Implementing research into practice
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The document discusses implementation science, focusing on the effective and sustainable integration of evidence-based interventions to reduce injuries in organizations. It identifies key barriers such as the lack of adoption, fidelity, sustainability, and scalability of interventions. Furthermore, it emphasizes the importance of aligning interventions with organizational practices, ensuring adequate resources, and fostering readiness among implementers and stakeholders.
Vicky Scott: Implementing research into practice
- 1. Implementing Research into Practice Vicky Scott, RN, PhD Clinical Professor, Faculty of Medicine, School of Population and Public Health, University of British Columbia
- 2. Implementation Science Implementation Science: is the scientific study of variables and conditions that impact changes at practice, organization and systems levels; changes that are required to promote the systematic uptake, sustainability and effectiveness of evidence-based programs and practices in typical service and social settings. (Blase and Fixsen, 2010, NIRN ) The goal of this presentation is to help you to incorporate interventions to reduce injuries into your organizations in a way that is both effective and sustainable
- 3. Interventions Alone Not Enough
- 4. Why evidence is not enough Findings from the National Implementation Research Network reveal four main reasons why proven evidence-based interventions do not produce results as intended: 1. What is known is not what is adopted 2. What is adopted is not used with fidelity 3. What is adopted is not sustained for long enough 4. What is adopted is not used on a scale that would have a broad impact
- 5. Practitioners do not use “experimental rigor”, they use programs.
- 6. Operationalization Researchers and implementers working together to: – Define intervention core elements – Define principles and values that underpin the intervention (e.g., autonomy of recipients) – Define intended population – Support all implementation stages – Understand the implementation context
- 8. NEED CAPACITY FIT READINESS RESOURCES EVIDENCE Implementation Context http://implementation.fpg.unc.edu
- 9. 1. Need • Data indicating need • Significance of the issue • Perception of need by staff and recipients
- 10. 2. Fit with Current Practice • Aligns with organization’s priorities • Compatible with organization structures, policies and practices • Compatible with community values and beliefs
- 11. 3. Resources • Administration support • Physical setting • Technology and data supports • Implementation expertise • Staffing and supervisors • Training and coaches
- 12. 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
- 13. 4. Evidence • Outcome – is it worth it? • Fidelity of data • Population similarities, e.g., age, health and culture • Cost effectiveness • Efficacy or effectiveness • Number/quality of studies
- 15. 5. Readiness • Expert trainers • Qualifications of implementers and evaluators • Mature site to observe • Operational definitions of core functions • Usability pilot (Plan, Do, Study, Act)
- 16. PDSA Cycle Trial and learn to identify core components and active ingredients to further evaluate, improve and discard non-essential components. Do in partnership with researchers, program developers and early implementers. Usability Pilot
- 17. 6. Capacity • Buy-in process operationalized – Practitioners – Recipients of interventions • Sustainability – Staff competencies – Organization data support – Leadership adaptability – Financial and technical support • Continuous quality improvement supported by shared learning and audits of competency
- 18. Competency Drivers • Selection: of staff with the required knowledge, basic skills and abilities • Training: of staff on new skills and practices and when, how and with whom they will be used • Coaching: of staff to oversee the practice and mastering of new skills on the job. Performance assessments are key.
- 19. NEED CAPACITY FIT READINESS RESOURCES EVIDENCE Scoring Your Readiness High =5 Med =3 Low =1 1. Need 2. Fit 3. Resources 4. Evidence 5. Readiness 6. Capacity Total Score http://implementation.fpg.unc.edu
- 20. Thank you! Kiitos to our Finnish hosts for inviting us to their beautiful country!
Editor's Notes
- #4: Implementation = The HOW Intervention = The WHAT
- #6: To address this issues we need to realize…
- #7: Autonomy: capacity of a rational individual to make an informed, un-coerced decision
- #8: In other words, researchers and implementers need to work as one team for effective implementation
- #9: For effective operationalization it is recommended to understand the implementation context – these six areas illuminate how this is done
- #13: This course is designed to provide you with a solid theoretical foundation in the science of falls prevention as well as the art of program planning for falls prevention. The course participants are typically health professionals, community leaders, or persons involved in fall and injury prevention policy.
- #16: Implementation components operationalized: Organizational support – of leaders, staff administration and affiliated systems Leadership – systems expert/coaches Staff competency – performance assessments/auditing tools