The Evolution of Implementation Science
According to a study by the National Health Institute, research-based practices currently take about 17 years to reach clinical use. This means that even after new health practices have been tested for safety and efficacy, the general public won’t use them with regularity for close to 20 years. That’s two decades of squandered time that could improve or even save hundreds of thousands of lives.
For years, implementation scientists have aimed to reduce this time, increasing the application of research-based practices in communities around the world. However, as a recently developed field of healthcare science, many wonder where implementation science first began.
In this article, we discuss the history of implementation science, including what it is and how its inception has influenced the study and implementation of research-based practices today.
What Implementation Science Is (and What It Isn’t)
Individuals with only a passing familiarity with implementation science may assume that it’s used to determine whether a proposed new healthcare practice is safe and effective. In reality, that clinical research takes place before implementation scientists begin their job.
So what is the role of an implementation scientist?
The journal Psychiatric Research states that the objective of implementation scientists “is not to establish the health impact of a clinical innovation, but rather to identify the factors that affect its update into routine use.”
Put simply, implementation science focuses on:
- identifying barriers that limit the use of innovations in various sectors, and
- developing specific implementation strategies to overcome those challenges.
A successful implementation aims to increase the number of healthcare providers and organizations who regularly incorporate a new intervention into their healthcare space.
Key Milestones in Implementation Science
This quickly growing sector in the health sciences has come a long way since its inception less than 100 years ago. Below, we explore some of the turning points in the history of implementation science.
Early Development
While 17 years may seem like a long time for an evidence-based practice to reach clinical use, consider this: In 1601, it was observed that citrus cured scurvy. However, despite a successful trial in the early 1700s, the British Navy didn’t start providing citrus to sailors until 1795. Between the 16th and 18th centuries, scurvy killed more than 2 million sailors, which may have been prevented if sailors had included citrus in their diets sooner.
This example shows that even when healthcare practices were documented as successful, they weren’t always quickly adopted. Fast forward to the 1960s, when researchers like Everett Rogers began to question why evidence-based practices weren’t being more rapidly adopted by the healthcare system.
Rogers developed the Diffusion of Innovation Theory, which explained how new ideas or practices spread through society over time. His theory became the foundation of implementation science, aiming to bridge the gap between research and practice.
Establishing a Formal Discipline and Developing a Framework
Between the mid-1900s and now, implementation science has developed rapidly. Early studies concentrated on finding gaps in the slow regulation process of new healthcare practices and discovering the barriers that stood between innovation and widespread adoption. Modern-day implementation science research, however, focuses on developing theories and frameworks that improve the implementation process.
In addition to Rogers’ classic Diffusion of Innovation Theory, some of the contemporary frameworks that form the basis of modern implementation science research include:
- RE-AIM Framework
The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework evaluates research results and translates them into practice to help them achieve success in real-world settings, such as hospitals, physician’s offices and community centers.
- The Ottawa Model of Research Use
This framework uses multiple steps to identify potential barriers and guide successful implementation. The Ottawa model relies heavily on continuous monitoring and evaluation to assess effectiveness and adjust for best outcomes.
- PRECEDE-PROCEED Model
This model helps develop and improve public health programs. The PRECEDE portion of the model plans programs by assessing community health needs and identifying their program’s focus. The PROCEED portion puts the program into action and evaluates its effectiveness.
Become a Pioneer in Implementation Science at UF
As a relatively new field, implementation science is quickly advancing to more effectively accelerate the integration of new evidence-based methods in real-world settings. If you’re ready to help speed the adoption of innovative interventions, our online Graduate Certificate in Implementation Science can help you begin or advance your career in this burgeoning industry.
Our 11-credit online program is designed for busy professionals looking to expand their skills in healthcare sciences. So, whether you’re a nurse, health educator, medical scientist or pursuing another career in the industry, you can complete all four courses and earn your graduate certificate in as little as one year.
With courses taught year-round by renowned professors and a flexible format that lets you earn a credential from one of U.S. News’ top-50 national universities at your own pace, what’s stopping you from jumpstarting your career? Apply today!
Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3241518/
https://www.sciencedirect.com/science/article/pii/S016517811930602X
https://www.sciencehistory.org/stories/magazine/the-age-of-scurvy/
https://impsci.med.ufl.edu/3-pioneers-in-the-field-of-implementation-science/
https://ktdrr.org/products/kt-implementation/rise-of-implementation-science.html
https://re-aim.org/learn/what-is-re-aim/
https://www.ruralhealthinfo.org/toolkits/health-promotion/2/theories-and-models/precede-proceed