Bea Brown, Sax Institute

1. Implementation research -
complementing evidence-based
medicine with evidence-based
implementation
Bea Brown
HARC Scholarship 2013

2. “Australia needs a stronger connection between health and
medical research, and the delivery of health-care services.
Embedding research into health care will ensure
government investment in research benefits all Australians
– through better health outcomes – and delivers the
greatest economic value.”
Simon McKeon, Strategic Review of Health and Medical
Research Final Report February 2013

3. SCHOLARSHIP OBJECTIVES
• Develop skills in the development of implementation strategies to
bring about change in practice and quality improvement.
• Develop skills in the evaluation of the implementation of quality
and safety programs so as to be able to generate new evidence
about what works, for whom, why and under what circumstances.
• Strengthen existing relationships and forge new links between the
Sax Institute and international experts in health services and
implementation research

4. SUMMARY OF US STUDY TOUR
• Department of Veterans Affairs (VA) Los Angeles
• HSR&D Center of Excellence for the Study of Healthcare Provider
Behavior
• Center for Implementation Practice and Research Support
• RAND Corporation
• UCLA Medical School
• Kaiser Permanente Southern California
• Implementation Research Team
• Global Implementation Conference, Washington DC

5. LESSONS LEARNT
• Establishing organisational readiness for change is critically
important prior to commencing any type of quality improvement
initiative
• Assessment of existing strengths and deficiencies should be
undertaken to enable tailoring of implementation efforts
• Clinician involvement in the quality improvement process is
pivotal to increase compliance and maximize the potential for
behavior change and improved outcomes
• Intervention elements that become routine practice i.e. “the way
things are round here” tend to be most effective
• The level of involvement of the implementation team has
implications for engagement, sustainability and fidelity
• Significant change in practice is very difficult to achieve

6. KEY OUTCOMES
• Lessons learnt directly informed the development of the Clinician-
Led Improvement in Cancer Care (CLICC) implementation trial that
aims to increase understanding about how clinical networks can
be utilised as effective agents for change
• Process outcome and fidelity measures to evaluate the
implementation strategy employed in the study using a “hybrid
type 2” effectiveness-implementation study design, giving equal
attention to the effectiveness of the clinical intervention and the
implementation strategy to support the intervention.

7. SUPPLEMENTARY OUTCOMES
• Increased knowledge of models and frameworks relevant to
dissemination and implementation of research into practice
• Expertise in the development, implementation and evaluation of
quality improvement programs
• International exposure in the Implementation Science/Research
field through presentations at conferences and workshops
• Numerous relationships with internationally leading experts in the
health services and implementation research fields providing
opportunity for future collaboration
• Ongoing opportunities to implement lessons learned

8. THANK YOU TO THE HARC
PARTNERS