Making Implementation Science Work for Your Change Initiatives
By Dr. Sobia Khan, Director of Implementation
7-min read
There's no doubt that the application of implementation science is steadily growing. Over the past few years, numerous organizations and groups that have approached us at The Center for Implementation have asked for ways to incorporate implementation science into their programs and workflows. While this is incredibly exciting for us (obviously, we are big proponents of implementation science!), we have also seen the tension that this can cause. So many organizations and groups spend years defining their own approaches to change or subscribing to courses, tools, and materials that describe methods rooted in quality improvement, change management, improvement science or other change-related fields. All of a sudden, implementation science is being introduced and lauded as a route to achieving change and transformation, and many people are being asked to change course to align with this new way of knowing and doing.
Barriers and fears to adopting implementation science
After talking to many people about implementation science, we have heard about people’s deep-seated fears about adopting implementation science. These fears often stem from the idea that implementation science is seen as the new “hot thing to do,” and people worry that the years they have spent building skills in their current approach to change (e.g., quality improvement or change management approaches) will be erased and feel meaningless. They are concerned that introducing this new “hot approach” means everyone will need to fundamentally shift how they approach change. Some feel this is indirectly an insult, implying that what they are currently doing is not good.
The secret to adopting implementation science approaches
We think now is a great time to let you in on a little secret:
If you want to adopt implementation science approaches, you do not need to completely overhaul what you are currently doing.
Implementation science, like many other fields, has its key strengths, and it also has areas for improvement (i.e., ways that implementation science could be better than it currently is). The important thing here is to take the key strengths from implementation science and use them to enhance what you are already doing.
Enriching approaches to change with implementation science
A really concrete example is a topic we have covered before – how to merge quality improvement and implementation science. Many organizations have deeply entrenched quality improvement models that they have been using for years and dedicated quality improvement specialists. Instead of scrapping quality improvement to replace it with implementation science, it makes more sense to be explicit about what quality improvement is not so good at doing and to use key strengths from implementation science to supplement it. Specifically, quality improvement is great at describing cyclical and iterative processes of change. It does not do a fabulous job of producing evidence and theory to describe mechanisms and theories of change, which can help with the strategy selection and planning processes in quality improvement. This is where implementation science can help; adding in implementation science components to the existing processes can boost what people are already doing rather than replacing what they are doing.
There are many other examples of how implementation science can help maximize how people facilitate and stimulate change. We think the deep understanding of how to link strategies to mechanisms and determinants of change is one thing that implementation science can offer any organization or group, and that can be easily embedded into what the organization or group already does. Other gems include understanding organizational readiness, and concepts emerging around functions and forms to guide adaptable components of programs, and mechanisms for sustainability, scale and spread. Again, taking these components and adding them to existing models can be incredibly beneficial.
Ways to enhance implementation science approaches
While we are here, we should also acknowledge the flip side of this. If you are a die-hard implementation science nerd, it is helpful to know that the field has room for improvement and could benefit from what we know works from other fields. For example, implementation science is not great at acknowledging the social processes of change like trust building and power dynamics – this is starting to change, but there is so much we can learn by merging what we know about trust and power from the social sciences and community work to and embed this into implementation science. The same is true for our understanding of macro systems; there is a whole field of systems science that can help improve our application of implementation science for large-scale change.
The bottom line is that change is complex and hard; one approach does not have all the answers; and therefore, you do not have to pledge allegiance to one field, method or approach to improve your change efforts.
The goal is not to pick one approach over the other but to integrate the best of both or all worlds.
Thinking critically about what can contribute to positive and successful change and what fields have built a large knowledge base in certain areas to borrow from and embed into your current processes can help people within organizations and groups feel like approaches to change are intentional and not just the “hot thing to do.” Plus, this approach feels less threatening; it values the skills and experience that everyone brings.
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