Methodology Issues in Implementation Science

Four case studies on recommendations to advance implementation science.

Implementation science—the study of methods, interventions, and variables in the adoption of evidence-based practices—holds promise for improving health care delivery and value.

These authors describe four studies funded by RWJF’s Interdisciplinary Nursing Quality Research Initiative (INQRI) and related methodological issues.

Case 1: Engaging Frontline Nursing Staff in Quality Improvement identified and addressed micro-system-level operational failures encountered in frontline patient care.

Case 2: Effectiveness of Readiness for Hospital Discharge to Reduce Readmission evaluated the relationships among staffing, nursing perceptions of readiness for discharge, and inpatient 30-day readmission rates.

Case 3: Translating Fall Risk Status Into Interventions to Prevent Patient Falls developed and evaluated a fall-prevention toolkit that included a bed poster, patient education handout, and fall prevention plan of care.

Case 4: Phased Cluster Randomized Trial Testing of a Collaborative to Improve Heart Failure Care tested the effectiveness of a quality collaborative toolkit to enhance adoption of best practices in heart failure care in rural hospitals.

The following recommendations were made by the authors to advance methods in implementation science:

  • Develop a core set of implementation concepts and metrics.
  • Generate standards for implementation methods that include pragmatic trials, mixed methods designs, and complex interventions and measurement.
  • Endorse reporting standards for implementation studies.