HCI3 Exam 2 - Implementation Science

conscious, explicit judicious use of current best evidence in making decisions about individual patients

evidence-based medicine (EBM)

maturation of implementation science leading to expansion of field to include ________

dissemination

advances in pharmacist roles as direct patient care providers and pop health team members

clinical practice

bold leadership required to navigate rapidly evolving and dynamic environments

adaptive leadership

building a sense of urgency as well as engaging and enabling the organization to implement and sustain the change

change management

study of methods to promote the uptake of research findings into routine health care in clinical, organizational, or policy contexts

implementation science (IS)

How do we get evidence adopted and sustained at scale?

the primary question that involves the concept of implementation science

focus on whether an invention works

efficacy and effectiveness

focus on how and why interventions work or fail to work in real-world settings

implementation science

efforts typically focus on solving health care delivery problems in specific contexts

quality improvement

T/F: implementation science and quality improvement have overlap in their methods of application due to being rooted in similar approaches and principles

true

the emphasis of quality improvement is ________ (implementation & delivery/rapid-cycle testing)

rapid-cycle testing

_______ goal is to solve health care delivery problems in specific contexts

quality improvement

_____ goal is to create generalizable knowledge to be applied/replicated beyond individual contexts/systems studied

implementation sceince

implementation science has a _____ (narrower/broader) focus than quality improvement

broader

a service or practice supported by evidence

evidence-based intervention (EBI)

initial decision to use an intervention

adoption

continues use after initial launch

sustainability

delivering the interventions as intended

fidelity

effects of deliberate and purposeful actions taken to implement new treatments, practices, and services

implementation outcomes

3 main categories of implementation science frameworks

determinant, process, and evaluation

understanding/explaining factors that influence implementation outcomes

determinant frameworks

translating research into practice

process frameworks

evaluating the implementation of a new practice

evaluation frameworks

most widely used framework for identifying barriers and facilitators that affect implementation success

consolidated framework for implementation research (CFIR)

the five domains of CFIR

innovation characteristics, outer/inner setting, individual, and implementation process

CFIR - policies, regulations, payer requirements, patient needs, and expectations

outer setting

CFIR - organizational culture workflow, and resources

inner setting

CFIR - knowledge, skills, beliefs, and attitudes

individuals

CFIR - planning, engaging stakeholders, executing, and evaluating

implementation process

= why implementation succeeds or fails

CFIR

primarily an evaluation framework used to determine whether a program has meaningful public health impact; did the program make a difference?

RE-AIM framework

define the RE-AIM framework

reach, effectiveness, adoption, implementation, and maintenance

focuses on the stage of implementation over time

EPIS

define EPIS framework

exploration, preparation, implementation, and sustainment

= before, during, and after implementation

EPIS

8 core implementation outcomes to evaluate success

acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, and sustainability

perception that a given innovation is agreeable, palatable, or satisfactory

acceptability

perceived fit, relevance, or compatibility of the innovation for a given practice setting, provider, or consumer, and/or perceived fit of the innovation to address a particular issue or problem

appropriateness

extent to which an innovation can be successfully used or carried out within a given setting

feasibility

integration of an innovation within a service setting and its subsystems

penetration