FAST: A Framework to Assess Speed of Translation of Health Innovations to Practice and Policy

Abstract

The 17-year time span between discovery and application of evidence in practice has become a unifying challenge for implementation science and translational science more broadly. Further, global pandemics and social crises demand timely implementation of rapidly accruing evidence to reduce morbidity and mortality. Yet speed remains an understudied metric in implementation science. Prevailing evaluations of implementation lack a temporal aspect, and current approaches have not yielded rapid implementation. In this paper, we address speed as an important conceptual and methodological gap in implementation science. We aim to untangle the complexities of studying implementation speed, offer a framework to assess speed of translation (FAST), and provide guidance to measure speed in evaluating implementation. To facilitate specification and reporting on metrics of speed, we encourage consideration of stakeholder perspectives (e.g., comparison of varying priorities), referents (e.g., speed in attaining outcomes, transitioning between implementation phases), and observation windows (e.g., time from intervention development to first patient treated) in its measurement. The FAST framework identifies factors that may influence speed of implementation and potential effects of implementation speed. We propose a research agenda to advance understanding of the pace of implementation, including identifying accelerators and inhibitors to speed.

Applying concepts from “rapid” and “agile” implementation to advance implementation research

“…Despite the challenges inherent to rapid implementation, we agree with Proctor et al [ 18 ] that the public health challenges of our time demand timely implementation. Even in cases where de-implementation may be later required (which are not limited to innovations that are rapidly implemented), mechanisms used in rapid implementation may also assist to more rapidly engage in de-implementation.…”

“…Despite the urgency to increase the timeliness of implementation, rapid implementation can cause unintended consequences. Proctor et al [ 18 ] explore the trade-offs in prioritizing implementation speed and explore the argument that “implementation occurs too slowly, versus implementation should not be rushed.” Since rapid implementation redefines rigor , there is the possibility that innovations implemented may be more likely than others to require de-implementation, meeting the criteria established by McKay et al [ 19 ] in being ineffective or harmful, not the most effective or efficient, or no longer necessary.…”

Factors Associated with The Speed and Scope of Diffusion of COVID-19 Therapeutics in a Nationwide Healthcare Setting: A Mixed Methods Investigation

“…In the FAST Framework for considering factors that drive the speed of practice change, Proctor et al highlight different systems and contextual factors that theoretically impact speed and scope of information sharing. 23 Our study adds to the current literature by including real-world data about the adoption and de-adoption of various therapeutic options and correlating changes with speci c events and internal and external factors that were associated with these changes. The explanatory Speed and Scope of Diffusion Matrix could be used and re ned in future studies to predict the how practice change may occur when new medications and interventions become available based on characteristics of the intervention and the context in which it is being introduced.…”

Factors Associated with The Speed and Scope of Diffusion of COVID-19 Therapeutics in a Nationwide Healthcare Setting: A Mixed Methods Investigation

“…In the FAST Framework for considering factors that drive the speed of practice change, Proctor et al highlight different systems and contextual factors that theoretically impact speed and scope of information sharing. 31 Our study adds to the current literature by including real-world data about the adoption and de-adoption of various therapeutic options and correlating changes with speci c events and internal and external factors that were associated with these changes. The explanatory Speed and Scope of Diffusion Matrix could be used and re ned in future studies to predict the how practice change may occur when new medications and interventions become available based on characteristics of the intervention and the context in which it is being introduced.…”