Ten years of implementation outcome research: a scoping review protocol

Abstract

IntroductionA 2011 paper proposed a working taxonomy of implementation outcomes, their conceptual distinctions and a two-pronged research agenda on their role in implementation success. Since then, over 1100 papers citing the manuscript have been published. Our goal is to compare the field’s progress to the originally proposed research agenda, and outline recommendations for the next 10 years. To accomplish this, we are conducting the proposed scoping review.Methods and analysisOur approach is informed by Arksey and O’Malley’s methodological framework for conducting scoping reviews. We will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. We first aim to assess the degree to which each implementation outcome has been investigated in the literature, including healthcare settings, clinical populations and innovations represented. We next aim to describe the relationship between implementation strategies and outcomes. Our last aim is to identify studies that empirically assess relationships among implementation and/or service and client outcomes. We will use a forward citation tracing approach to identify all literature that cited the 2011 paper in the Web of Science (WOS) and will supplement this with citation alerts sent to the second author for a 6-month period coinciding with the WOS citation search. Our review will focus on empirical studies that are designed to assess at least one of the identified implementation outcomes in the 2011 taxonomy and are published in peer-reviewed journals. We will generate descriptive statistics from extracted data and organise results by these research aims.Ethics and disseminationNo human research participants will be involved in this review. We plan to share findings through a variety of means including peer-reviewed journal publications, national conference presentations, invited workshops and webinars, email listservs affiliated with our institutions and professional associations, and academic social media.

Six practical recommendations for improved implementation outcomes reporting

“…Second, this paper was not an abstract theoretical exercise. The development of the proposed recommendations—and the realization of the need to do so—was directly informed by our hands-on experience conducting a scoping review [ 25 ]. Third, our recommendations can be used to elaborate upon outcomes-related sections of existing guidelines.…”

“…As part of a scoping review aimed at describing how the field conceptualized, measured, and advanced theory around implementation outcomes since 2011 [ 25 ], we identified 358 empirical studies published in peer-reviewed journals that cited the original paper and assessed one or more implementation outcomes. We found that while anchored by the conceptual definitions from the 2011 taxonomy, these studies varied substantially in how implementation outcomes were reported.…”

“…To identify current reporting problems and generate meaningful recommendations, we leveraged elements of the data charting stage of our scoping review methodology [ 25 ]. During data charting, team members trained in implementation research reviewed full-text articles to identify the implementation outcomes examined, measurement approaches, and other study details.…”

Health System Resilience: Withstanding Shocks and Maintaining Progress

“…For example, the Exploration, Preparation, Implementation, and Sustainment framework emphasizes sustainability integrated as a critical part of implementation. 17 Additionally, sustainability, defined as “the extent to which a newly implemented treatment is maintained or institutionalized within a service setting’s ongoing, stable operations,” 18 is often an implementation outcome that strategies are evaluated against.…”

Conducting Implementation Research in Stroke Rehabilitation: A Case Example and Considerations for Study Design

“…As defined by Proctor et al, 43 implementation outcomes are “the effects of deliberate and purposive actions to implement new treatments, practices, and services.” In addition to the aforementioned RE-AIM model, other implementation outcomes include acceptability, adoption, appropriateness, costs, feasibility, fidelity, penetration (or reach), and sustainability. 44,45 Options for measuring these outcomes include, for instance, (a) conducting focus groups with practitioners to determine the extent to which an intervention can be sustainably used in practice, (b) completing chart reviews to evaluate practitioners’ adoption of a particular intervention or standardized assessment, and (c) observing the behavioral patterns of practitioners to assess their level of fidelity to an intervention protocol. Proctor et al 43 provide in-depth descriptions of each of these implementation outcomes as well as recommendations for measurement.…”