The document discusses implementation science, focusing on the effective and sustainable integration of evidence-based interventions to reduce injuries in organizations. It identifies key barriers such as the lack of adoption, fidelity, sustainability, and scalability of interventions. Furthermore, it emphasizes the importance of aligning interventions with organizational practices, ensuring adequate resources, and fostering readiness among implementers and stakeholders.

1. Implementing Research into
Practice
Vicky Scott, RN, PhD
Clinical Professor, Faculty of Medicine, School of
Population and Public Health, University of British
Columbia

2. Implementation Science
Implementation Science: is the scientific study of variables and
conditions that impact changes at practice, organization and
systems levels; changes that are required to promote the
systematic uptake, sustainability and effectiveness of
evidence-based programs and practices in typical service and
social settings. (Blase and Fixsen, 2010, NIRN )
The goal of this presentation is to help you to incorporate
interventions to reduce injuries into your organizations in a
way that is both effective and sustainable

3. Interventions Alone Not Enough

4. Why evidence is not enough
Findings from the National Implementation Research
Network reveal four main reasons why proven
evidence-based interventions do not produce results as
intended:
1. What is known is not what is adopted
2. What is adopted is not used with fidelity
3. What is adopted is not sustained for long enough
4. What is adopted is not used on a scale that would have a
broad impact

5. Practitioners do not use
“experimental rigor”, they use
programs.

6. Operationalization
Researchers and implementers working together to:
– Define intervention core elements
– Define principles and values that underpin the
intervention (e.g., autonomy of recipients)
– Define intended population
– Support all implementation stages
– Understand the implementation context

8. NEED
CAPACITY FIT
READINESS RESOURCES
EVIDENCE
Implementation Context
http://implementation.fpg.unc.edu

9. 1. Need
• Data indicating need
• Significance of the issue
• Perception of need by staff and recipients

10. 2. Fit with Current Practice
• Aligns with organization’s priorities
• Compatible with organization structures, policies and
practices
• Compatible with community values and beliefs

11. 3. Resources
• Administration support
• Physical setting
• Technology and data
supports
• Implementation expertise
• Staffing and supervisors
• Training and coaches

12. 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

13. 4. Evidence
• Outcome – is it worth it?
• Fidelity of data
• Population similarities, e.g.,
age, health and culture
• Cost effectiveness
• Efficacy or effectiveness
• Number/quality of studies

15. 5. Readiness
• Expert trainers
• Qualifications of implementers and evaluators
• Mature site to observe
• Operational definitions of core functions
• Usability pilot (Plan, Do, Study, Act)

16. PDSA Cycle
Trial and learn to identify
core components and
active ingredients to
further evaluate, improve
and discard non-essential
components.
Do in partnership with
researchers, program
developers and early
implementers.
Usability Pilot

17. 6. Capacity
• Buy-in process operationalized
– Practitioners
– Recipients of interventions
• Sustainability
– Staff competencies
– Organization data support
– Leadership adaptability
– Financial and technical support
• Continuous quality improvement supported by
shared learning and audits of competency

18. Competency Drivers
• Selection: of staff with the
required knowledge, basic skills
and abilities
• Training: of staff on new skills
and practices and when, how and
with whom they will be used
• Coaching: of staff to oversee the
practice and mastering of new
skills on the job. Performance
assessments are key.

19. NEED
CAPACITY FIT
READINESS RESOURCES
EVIDENCE
Scoring Your Readiness
High
=5
Med
=3
Low
=1
1. Need
2. Fit
3. Resources
4. Evidence
5. Readiness
6. Capacity
Total Score
http://implementation.fpg.unc.edu

20. Thank you!
Kiitos to our Finnish hosts for inviting
us to their beautiful country!