HCI3 Exam 2 - Implementation Science

evidence-based medicine (EBM)

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

dissemination

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

clinical practice

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

adaptive leadership

bold leadership required to navigate rapidly evolving and dynamic environments

change management

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

implementation science (IS)

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

how do we get evidence adopted and sustained at scale?

the primary question that involves the concept of implementation science

efficacy and effectiveness

focus on whether an invention works

implementation science

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

quality improvement

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

true

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

rapid-cycle testing

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

quality improvement

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

implementation sceince

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

broader

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

evidence-based intervention (EBI)

a service or practice supported by evidence

adoption

initial decision to use an intervention

sustainability

continues use after initial launch

fidelity

delivering the interventions as intended

implementation outcomes

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

determinant, process, and evaluation

3 main categories of implementation science frameworks

determinant frameworks

understanding/explaining factors that influence implementation outcomes

process frameworks

translating research into practice

evaluation frameworks

evaluating the implementation of a new practice

consolidated framework for implementation research (CFIR)

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

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

the five domains of CFIR

outer setting

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

inner setting

CFIR - organizational culture workflow, and resources

individuals

CFIR - knowledge, skills, beliefs, and attitudes

implementation process

CFIR - planning, engaging stakeholders, executing, and evaluating

CFIR

= why implementation succeeds or fails

RE-AIM framework

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

reach, effectiveness, adoption, implementation, and maintenance

define the RE-AIM framework

EPIS

focuses on the stage of implementation over time

exploration, preparation, implementation, and sustainment

define EPIS framework

EPIS

= before, during, and after implementation

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

8 core implementation outcomes to evaluate success

acceptability

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

appropriateness

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

feasibility

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

penetration

integration of an innovation within a service setting and its subsystems