Implementation Science to Advance Care Delivery: A Primer for Pharmacists and Other Health Professionals

Abstract

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.

Community pharmacist patient care services: A systematic review of approaches used for implementation and evaluation

“…Using standardized taxonomies and reporting guidelines will enable the field to better reproduce and measure implementation strategies in order to better understand which strategy or combination of strategies is most effective for implementing community pharmacist patient care services. Furthermore, better labeling and describing of implementation strategies could enable pharmacists to utilize research findings more fully and enact patient care innovations or enhancements into practice more quickly closing the research‐to‐practice gap, and most importantly, improving patient care …”

“…D&I outcomes differ from the clinical, humanistic, and economic outcomes used in efficacy and effectiveness studies to determine whether a service works. Rather, D&I outcomes are measures to determine how or why a service did or did not work in clinical practice . Similar to the greater implementation science literature, reach, acceptability, and adoption were the D&I outcomes most frequently evaluated, while fidelity, sustainability, and penetration were the least frequently evaluated.…”

“…Scholarly efforts have primarily focused on demonstrating the effectiveness and value of these community pharmacist patient care services, also known as clinical interventions. While generation of evidence of the efficacy and effectiveness of a patient care service is important and necessary, it does not automatically translate into widespread adoption of the service in clinical settings . Rather, active, systematic, and purposeful approaches are required to facilitate effective implementation of a patient care service.…”

“…Thus, widespread and sustained implementation of these services has been limited. When patient care services are poorly implemented and sustained, the desired clinical, humanistic, and economic outcomes are not achieved and the well‐being of patients and communities is not improved …”

Parenteral Nutrition Drug Shortages: A Single‐Center Experience With Rapid Process Change

“…Implementation of new practices is often a protracted process, but in emergency drug shortages, centers do not have the luxury of time. Systems to effectively and safely disseminate and implement therapeutic alternatives must be quickly assembled, resulting in a marked shift of personnel and technology resources to achieve goals .…”