1 Implementing and Using Stacks many slides taken from Mike Scott, UT Austin.
Vicky Scott: Implementing research into practice
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Implementing Research into Practice Vicky Scott, RN, PhD Clinical Professor, Faculty of Medicine, School of Population and Public Health, University of British Columbia
Transcript of Vicky Scott: Implementing research into practice
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!
