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SRAconf Plenary: Mind the implementation gap, Jane Lewis

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"MIND THE IMPLEMENTATION GAP: How implementation science helps get research into practice" Jane Lewis, Director of Implementation Support, The Colebrooke Centre for Evidence and Implementation at the …

"MIND THE IMPLEMENTATION GAP: How implementation science helps get research into practice" Jane Lewis, Director of Implementation Support, The Colebrooke Centre for Evidence and Implementation at the SRA annual conference 2013


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  • 1. MIND THE IMPLEMENTATION GAP How implementation science helps get research into practice SRA annual conference 9 December 2013 Jane Lewis Director of Implementation Support The Colebrooke Centre for Evidence and Implementation
  • 2. About the Colebrooke Centre • first and only UK centre specialising in implementation science and practice in child and family services • social enterprise, not-for-profit • services – design and selection of interventions – implementation strategies and support – implementation evaluation • for local government, voluntary sector, central government, philanthropies, improvement bodies • leading application and development of implementation theory, evidence and frameworks for UK context © Colebrooke Centre for Evidence and Implementation 2013
  • 3. Evaluation of My Baby’s Brain – Hertfordshire County Council © Colebrooke Centre for Evidence and Implementation 2013
  • 4. Let Teachers Shine – Shine Foundation © Colebrooke Centre for Evidence and Implementation 2013
  • 5. The science-practice gap © Colebrooke Centre for Evidence and Implementation 2013
  • 6. The science-practice gap Research dissemination and translation initiatives © Colebrooke Centre for Evidence and Implementation 2013
  • 7. Blank slide for charts etc. © Colebrooke Centre for Evidence and Implementation 2013
  • 8. The science-practice gap Research dissemination and translation initiatives © Colebrooke Centre for Evidence and Implementation 2013
  • 9. The science-practice gap Implementation Research dissemination and translation initiatives © Colebrooke Centre for Evidence and Implementation 2013
  • 10. The implementation gap • what is known is not adopted by policy / practice but also … • what is adopted is not operationalised as intended • what is operationalised as intended is not sustained • what is operationalised as intended is not used at scale © Colebrooke Centre for Evidence and Implementation 2013
  • 11. Implementation • active and planned efforts to identify approaches that (will) work and to deliver them sustainably and at scale in ways that maximise their effectiveness • from letting it happen to helping it happen to making it happen (Greenhalgh et al, 2004) • ‘the nexus between research and practice’ (Chaudoir et al, 2013) © Colebrooke Centre for Evidence and Implementation 2013
  • 12. © Colebrooke Centre for Evidence and Implementation 2013
  • 13. The emergence of implementation science • systematic study of implementation informed by theory – processes, strategies, contexts – to produce evidenced and replicable methods, frameworks and systems • draws on all research methods • beyond evidence-based programmes and narrow questions of fidelity (Ghate, 2013) © Colebrooke Centre for Evidence and Implementation 2013
  • 14. Implementation matters! “The level of implementation achieved is an important determinant of programme outcomes. Achieving good implementation … can lead to much stronger benefits for participants.” Durlak and Dupre, 2008 – review of over 500 quantitative studies © Colebrooke Centre for Evidence and Implementation 2013
  • 15. Anything times zero is zero effective practices effective implementation enabling contexts Used with permission of NIRN © Colebrooke Centre for Evidence and Implementation 2013 intended outcomes
  • 16. What doesn’t work • disseminating research and good practice © Colebrooke Centre for Evidence and Implementation 2013
  • 17. © Colebrooke Centre for Evidence and Implementation 2013
  • 18. What doesn’t work • disseminating research and good practice • Just Do It © Colebrooke Centre for Evidence and Implementation 2013
  • 19. What doesn’t work • • • • disseminating research and good practice Just Do It training guidelines © Colebrooke Centre for Evidence and Implementation 2013
  • 20. © Colebrooke Centre for Evidence and Implementation 2013
  • 21. we need to get better at turning research into something that can be implemented © Colebrooke Centre for Evidence and Implementation 2013
  • 22. principles populations practices implementation supports © Colebrooke Centre for Evidence and Implementation 2013
  • 23. what is the ‘it’ in ‘does it work?’ or ‘should it be rolled out?’ © Colebrooke Centre for Evidence and Implementation 2013
  • 24. we need to get better at researching implementation © Colebrooke Centre for Evidence and Implementation 2013
  • 25. Implementation stages installation initial implement’n full implement’n exploration Fixsen et al, 2005; Metz and Barclay, 2012 © Colebrooke Centre for Evidence and Implementation 2013 sustained implement’n
  • 26. Implementation stages installation initial implement’n full implement’n exploration Fixsen et al, 2005; Metz and Barclay, 2012 © Colebrooke Centre for Evidence and Implementation 2013 sustained implement’n
  • 27. Implementation stages installation initial implement’n full implement’n sustained implement’n exploration Substantive innovations take 2-4 years to full implementation Fixsen et al, 2005; Metz and Barclay, 2012 © Colebrooke Centre for Evidence and Implementation 2013
  • 28. Implementation strategies planning policy context educating quality management financing infrastructure Powell et al, 2012 © Colebrooke Centre for Evidence and Implementation 2013
  • 29. Implementation drivers Integrated & Compensatory Leadership © Fixsen & Blasé, 2008
  • 30. A very chilling thought! “All organizations [and systems] are designed, intentionally or unwittingly, to achieve precisely the results they get” R Spencer Darling © Colebrooke Centre for Evidence and Implementation 2013
  • 31. Systems support for innovation Prism Prison © Colebrooke Centre for Evidence and Implementation 2013
  • 32. Where implementation outcomes fit in – expanding the ‘logic model’ Inputs Outputs Implemen tation Outcomes Service or treatment outcomes © Colebrooke Centre for Evidence and Implementation 2013 Impact
  • 33. Key messages • implementation matters – it’s key to getting research into policy and practice • moving forward requires partnerships • get better at turning research into something that can be implemented • get better at researching implementation • get better at implementation © Colebrooke Centre for Evidence and Implementation 2013
  • 34. References Chaudoir S, Dugan A and Barr C (2013) ‘Measuring factors affecting implementation of health innovations: a systematic review of structural, organizational, provider, patient, and innovation level measures’ Implementation Science 8:22 Durlak J and DuPre E (2008) ‘Implementation Matters: ‘A Review of Research on the Influence of Implementation on Program Outcomes and the Factors Affecting Implementation’ American Journal of Community Psychology 41: 327:350 Fixsen D, Naoom S, Blasé K, Friedman R and Wallace F (2005) Implementation Research: A synthesis of the literature National Implementation Research Network Tampa FL: University of South Florida Ghate D (2013) ‘Good enough: when is evidence-based intervention ready for dissemination?’ Pre-conference discussion paper for Jacobs Foundation conference London: The Colebrooke Centre for Evidence and Implementation http://www.cevi.org.uk/docs/Good_Enough_Ghate_2013.pdf Greenhalgh T, Robert G, MacFarlane F, Bate P and Kyriakidou O (2004) ‘Diffusion of Innovations in Service Organizations: Systematic Review and Recommendations’ Milbank Quarterly vol 82 (4) 582-629 Lipsey M (2009) ‘The primary factors that characterise effective interventions with juvenile offenders: a metaanalytic overview’ Victims and Offenders 4: 124-147 McIntosh K, Martinez R, Ty S and McClain M (2013) ‘Scientific research in school psychology: leading researchers weight in on its past, present and future’ Journal of School Psychology 51 267-318 Metz and Barclay (2012) ‘Active implementation frameworks for program success’ Zero to 3 March 2012 11-18 Meyers D, Durlak J and Wandersman A (2012) ‘The Quality Implementation Framework: A synthesis of critical steps in the implementation process’ American Journal of Community Psychology 50:462-480 Powell B, McMillen J, Proctor E, Carpenter C, Griffey R, Bunger A, Glass J and York J (2012) ‘A Compilation of Strategies for Implementing Clinical Innovations in Health and Mental Health’ Medical Care Research and Review 69(2) 123-157 © Colebrooke Centre for Evidence and Implementation 2013
  • 35. The Colebrooke Centre for Evidence and Implementation 55 St John Street London EC1M 4AN 0203 551 7666 jlewis@cevi.org.uk www.cevi.org.uk © Colebrooke Centre for Evidence and Implementation 2013

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