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The purpose of this exploratory study is to investigate organizational-level mechanisms in the Prevention Delivery System (PDS) and their influence on implementing comprehensive programming frameworks (e.g., Communities that Care-CtC) as the innovation. The PDS is part of the Interactive Systems Framework for Dissemination and Implementation (ISF) and describes key characteristics of innovation implementation and dissemination. The study addresses two research questions: (1) What types of organizational characteristics are related to successful use of each of the programming processes (i.e., planning, implementation, evaluation, and sustainability) that are part of comprehensive programming frameworks?; and (2) What are the similarities and differences in the organizational patterns correlated with use of each of the programming processes? Surveys, interview data, and other documents designed to assess organizational characteristics and extent of use of a comprehensive programming framework over time, were collected from 8 Community boards and 23 provider agencies. These organizations were responsible for planning and delivering substance abuse prevention services as part of a statewide initiative in Ohio. Data were analyzed using Spearman rho (and rank-biserial) correlations, with an emphasis on effect sizes. Results indicated that leadership, shared vision, process advocates, and technical assistance were common correlates of use across programming processes. However, the role played by these organizational variables differed for each programming process, pointing to complex interactions of the organizational infrastructure with other variables (i.e., characteristics of the innovation itself and external macro-level factors). This exploratory study provides preliminary data on the organizational-level mechanisms of the PDS and the complexity of their relationships with the other Systems in the Interactive Systems Framework.

Health care is experiencing increasing pressure to implement evidence-based interventions that improve quality, control costs, and maximize value. Unfortunately, many clinical services and interventions to optimize medication use do not consistently produce the intended humanistic, clinical, and economic outcomes. The lack of conclusive results is believed to stem from the widely recognized research-to-practice gap. The field of implementation science seeks to discover and apply strategies designed to accelerate successful integration of interventions into routine practice. This primer provides an overview of implementation science principles for pharmacists and other health care providers interested in accelerating practice transformation to improve health care delivery and, ultimately, patient care.

Funding informationAmerican College of Clinical Pharmacy (ACCP) and the ACCP Research InstituteThe implementation system described in this article is a customizable blueprint for delivery of comprehensive medication management (CMM) and other medication optimization services.This system is the result of merging implementation science expertise with lessons learned from the parent study, the "CMM in Primary Care" grant. This system is comprised of a number of components, including implementation steps and strategies (ie, activities, practical resources such as assessments and informational materials, and learning supports). While these components are integral to any implementation effort, this project describes their unique operationalization for delivery of CMM in a primary care context. Application of this system is illustrated through an example focused on improving the delivery of CMM by pharmacist-led teams in primary care settings. K E Y W O R D Scomprehensive medication management, implementation science, implementation system, pharmacy practice

Measuring the extent to which an intervention is implemented with fidelity (ie, as intended) is critical to its success. Comprehensive medication management (CMM) is an established pharmacy practice intervention in outpatient settings. However, there is no standardized approach to measuring its implementation fidelity. This article describes a fidelity assessment system that includes measures and tools for use by pharmacists and others involved with the practice of CMM. This system is a comprehensive but modular approach to assessing fidelity designed to facilitate measurement along three fidelity dimensions: context (ie, infrastructure needed to support CMM), content (ie, adherence to CMM), and competence (ie, skillset needed to deliver CMM). Practical recommendations with examples are also provided to facilitate application of the system in real‐world settings. These recommendations are designed to assist with prioritization of the fidelity dimensions to consider timing of the assessments, use of the resulting data, interpretation of the data, and translation of results into actionable decisions. Incorporating fidelity measurement into any CMM implementation effort is key to ensuring consistent care delivery and impactful clinical outcomes.