A3-1: The Just Do It Playbook for Implementation Science

Abstract

Background/Aims

There are over 60 published implementation science frameworks, and despite the advantages of each, none were designed to help clinicians and administrators to standardize and prioritize initiatives, implement programs efficiently, and evaluate with sufficient rigor.

Methods

In order to address these limitations, the Care Improvement Research Team (CIRT) at Kaiser Permanente Southern California blended implementation and behavior change frameworks into a structured process to help clinicians, operations leaders and researchers to standardize their approach and accomplish collaborative goals. To develop the “Just Do It Playbook,” we performed a pragmatic literature review, compared and synthesized published frameworks, and iteratively refined a set of steps for identifying, diagnosing and correcting gaps in care.

Results

The Just Do It Playbook can be simplified into four distinct steps: 1) describe the topic that needs improvement, 2) identify what or who needs to change, 3) develop an implementation strategy to facilitate change, and 4) evaluate the effectiveness of the strategy. The first step helps to prioritize the topic of interest and identifies whether there is a gap between current and best practices. Second, describing what or who needs to improve will enable identification of barriers or facilitators to change. The third step identifies strategies to promote best practices by using established behavior change theories as well as clearly defined and measurable outcomes. The final step evaluates the outcomes, costs and sustainability of the strategy, as well as the need to discontinue efforts, modify and re-evaluate, or disseminate to other settings.

Conclusions

In a learning health care system, there are many potential targets for improvement, and many strategies for implementation and evaluation. One way to simplify the complexities that inherently exist in health system improvement is to adopt a standardized approach. As clinicians, administrators and researchers forge meaningful collaborations, a standard process can improve the understanding of competing priorities, define roles and responsibilities, and integrate established scientific frameworks in a way that is efficient and sustainable. The Just Do It Playbook will need to be tested and adapted to individual projects, but will provide a platform to build embedded research into a functional operational standard.