Implementation Research: An Approach to Promote More Timely and Informative Synthesis for Real-World Implementation Findings - Set 1.

Damschroder LJ, Hall CG. Implementation Research: An Approach to Promote More Timely and Informative Synthesis for Real-World Implementation Findings - Set 1. Paper presented at: VA HSR&D National Meeting; 2011 Feb 17; National Harbor, MD.

Workshop Objectives: Translating evidence into practice requires that implementation researchers and leaders of clinical QI initiatives understand multi-faceted factors influencing success or failure of implementation. This workshop will demonstrate use of a consolidated implementation taxonomy to organize research findings from quantitative and qualitative assessments. This approach can improve and accelerate interpretive synthesis of findings across settings and studies to better understand which implementation strategies work in which settings and why. Additionally, it can enhance critique of theoretical frameworks used in individual studies. Activities: In Part 1, we will provide an overview of the Consolidated Framework for Implementation Research (CFIR), highlighting its utility in reporting qualitative and quantitative analyses. Templates and a conceptual approach to mapping findings will be presented. Two implementation studies in which quantitative and qualitative findings were mapped to the CFIR will be presented. The utility of these exercises and lessons learned will be highlighted. In Part 2, we will describe a study in which the Organizational Change Manager (OCM) developed by Gustafson, et al. was used to guide implementation of a new web-based clinical tool and the associated family-centered rehabilitation practice changes at four sites. Organization and interpretation of the quantitative findings to improve the likelihood of successful implementation will be described in respect to the OCM and CFIR. In Part 3, we will present qualitative findings from a mixed method explanatory case study guided by Pettigrew et al's content, context, and process model of strategic change. This in-depth case study of two contrasting hospitals explored the presence or absence of multiple, interrelated contextual factors and associated strategic approaches required for integrated, routine use of EBPs ('institutionalization'). This Workshop will conclude with an interactive audience discussion about the proposed approach: its challenges and utility; how implementation researchers may collaborate to test and refine this method, and prospects for using the proposed approach to synthesize findings across studies and settings through traditional literature syntheses and/or the utility of a central repository of findings. Target Audience: Researchers interested in implementation and individuals involved in clinical quality improvement initiatives within VA. Assumed Audience Familiarity with Topic: Basic familiarity with implementation research and/or quality improvement strategies is helpful.