When evidence thresholds are met, adopting healthcare innovations should add value, and this is forgone when evidence is not translated into practice. Activities that are not supported by evidence lead to ineffective or unnecessary care, or harm, poor outcomes, and low-value healthcare. This article provides an overview of implementation science, which is the scientific study of why implementation succeeds or fails. We draw parallels between the LEADS in a Caring Environment leadership framework and implementation science process models and frameworks. Taken together, the principles and practices in LEADS and the aims of implementation science are effectively quite similar and can be useful for healthcare management looking to optimize resources when implementing evidence-based practice and innovation into routine clinical care.
Get full access to this article
View all access options for this article.
References
1.
BraithwaiteJChurrucaKLongJCEllisLAHerkesJ. When complexity science meets implementation science: a theoretical and empirical analysis of systems change. BMC Med. 2018;16(1):63.
2.
HolmesBJBestADaviesH, et al.Mobilizing knowledge in complex health systems: a call to action. Evid Policy. 2017;13(3):539–560.
3.
BishopDLexchinJ. Politics and its intersection with coverage with evidence development: a qualitative analysis from expert interviews. BMC Health Serv Res. 2013;13:88.
4.
NaylorDFraserNGirardFJenkinsTMintzJPowerC. Report of the Advisory Panel on Healthcare Innovation. Ottawa, Ontario, Canada: Health Canada; 2015.
5.
CutlerDMMcClellanM. The value of innovation: is technological change in medicine worth it?Health Affair. 2001;20(5):11–29.
6.
Institute of Medicine (US) Committee on Technological Innovation in Medicine. In GelijnsACHalmEA, eds. The Changing Economics of Medical Technology. Washington, DC: National Academies Press (US); 1991. (Medical Innovation at the Crossroads, No. 2.) 2, The Diffusion of New Technology: Costs and Benefits to Health Care.
GrimshawJMEcclesMPLavisJNHillSHSquiresJE. Knowledge translation of research findings. Implement Sci. 2012;7:50.
9.
GrolR. Successes and failures in the implementation of evidence-based guidelines for clinical practice. Med Care. 2001;39(8 suppl 2):1146–1154.
10.
SchusterMAMcGlynnEABrookRH. How good is the quality of healthcare in the United States?Milbank Q. 1998;76(4):517–563.
11.
Canadian Institute for Health Information. Unnecessary Care in Canada. Ottawa, Ontario, Canada: Canadian Institute for Health Information; 2017.
12.
ShojaniaKGMcDonaldKMWachterRM, et al.Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies (Vol 1: Series Overview and Methodology). Technical Reviews No 9.1. Rockville, MD: Agency for HealthCare Research and Quality; 2004.
13.
GrolRGrimshawJM. Evidence-based implementation of evidence-based medicine. Jt Comm J Qual Improv. 1999;25(10):503–513.
14.
DenisJLBakerGRBlackC, et al.Exploring the Dynamics of Physician Engagement and Leadership for Health System Improvement: Prospects for Canadian Healthcare Systems. Ottawa, Ontario, Canada: Canadian Foundation for Healthcare Improvement; 2013.
15.
Collins-NakaiR. Leadership in medicine. McGill J Med. 2006;9(1):68–73.
16.
GreenhalghTRobertGMacfarlaneFBatePKyriakidouO. Diffusion of innovations in service organizations: systematic review and recommendations. Millbank Q. 2004;82(4):581–629.
17.
AtkinsL. Using the behaviour change wheel in infection prevention and control practice. J Infect Prev. 2016;17(2):74–78.
18.
RamaswamyRReedJLivesleyN, et al.Unpacking the black box of improvement. Int J Qual Health Care. 2018;30(suppl 1):15–19.
19.
GouldD. Auditing hand hygiene practice. Nurs Stand. 2010;25(2):50–56.
20.
MarchildonGPFletcherAJ. Prioritizing health leadership capabilities in Canada: testing LEADS in a caring environment. Healthc Manage Forum. 2016;29(1):19–22.
21.
EcclesMPMittmanBS. Welcome to implementation science. Implement Sci. 2006;1:1–3.
22.
PowellBJMcMillenJCProctorEK, et al.A compilation of strategies for implementing clinical innovations in health and mental health. Med Care Res Rev. 2012;69(2):123–157.
23.
DicksonG.The LEADS in a Caring Environment Leadership Capability Framework: Building Leadership Capacity in Canada to Lead Systems Transformation in Health. Communique, Canadian College of Health Leaders; 2010. Available at: http://chlnet.ca/wp-content/uploads/LEADS_Communique_Feb2010_LEADS_EN.pdf.
24.
KleinKJConnABSmithDBSorraJS. Is everyone in agreement? An exploration of within-group agreement in employee perceptions of the work environment. J Appl Psychol. 2001;86(1):3–16.
25.
NilsenP. Making sense of implementation theories, models, and frameworks. Implement Sci. 2015;10:53.
AaronsGAEhrhartMGFarahnakLRSklarM. Aligning leadership across systems and organizations to develop a strategic climate for evidence-based practice implementation. Annu Rev Public Health. 2014;35:255–274.
28.
GrolR. Beliefs and evidence in changing clinical practice. BMJ. 1997;315(7105):418–421.
29.
ForsetlundLBjørndalARashidianA, et al.Continuing education meetings and workshops: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev. 2009;15:CD003030.
IversNJamtvedtGFlottorpS, et al.Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev. 2012;13:CD000259.
32.
AaronsGAHurlburtMHorwitzSM. Advancing a conceptual model of evidence-based practice implementation in public service sectors. Adm Policy Ment Health. 2011;38(1):4–23.
33.
BrehautJCColquhounHLEvaKW, et al.Practice feedback interventions: 15 suggestions for optimizing effectiveness. Ann Intern Med. 2016;164(6):435–441.
34.
SquiresJEGrahamIDGrinspunD, et al.Inappropriateness of healthcare in Canada: a systematic review protocol. Syst Rev. 2019;8(1):50.
