What Is Implementation Science?

Pro­grams and prac­tices to improve child out­comes often start small, with an idea, some gen­er­al data, a the­o­ry of change and a plan. But what are the con­di­tions — the peo­ple, the poli­cies, the resources — that real­ly deter­mine whether the pro­gram will suc­ceed or fail?

Imple­men­ta­tion sci­ence strives to under­stand the crit­i­cal fac­tors and con­di­tions that ensure effec­tive prac­tices are suc­cess­ful­ly car­ried out and sus­tained in typ­i­cal ser­vice set­tings, whether that prac­tice is just being devel­oped or has already built sub­stan­tial evi­dence. It’s a field that rec­og­nizes that real life often doesn’t line up with the para­me­ters of a con­trolled eval­u­a­tion — and that lead­er­ship qual­i­ties and tran­si­tions, com­mu­ni­ca­tion and com­mu­ni­ty dynam­ics can play a sig­nif­i­cant yet under­ap­pre­ci­at­ed role.

Rec­og­niz­ing that its mis­sion depends on suc­cess­ful imple­men­ta­tion of effec­tive pro­grams to reach large pop­u­la­tions of chil­dren and fam­i­lies, the Casey Foun­da­tion has start­ed to focus on imple­men­ta­tion sci­ence with a port­fo­lio called Steps to Success.

“Steps to Suc­cess is about doc­u­ment­ing, under­stand­ing and refin­ing the prac­ti­cal steps we need to take to bring effec­tive strate­gies to scale,” said Suzanne Barnard, direc­tor of the Foundation’s Evi­dence-Based Prac­tice Group. ​“We believe that if we work togeth­er with researchers, sys­tem lead­ers, pro­gram devel­op­ers and peo­ple they serve, we can make sure that inter­ven­tions will live up to their poten­tial for large num­bers of kids, fam­i­lies and communities.”

Imple­men­ta­tion sci­ence devel­oped in the health care field, as researchers real­ized that proven treat­ments often failed to be imple­ment­ed and sus­tained in usu­al care. Increas­ing­ly, human ser­vices are apply­ing its con­cepts in a quest for sus­tained efforts and bet­ter outcomes.

The Nation­al Imple­men­ta­tion Research Net­work (NIRN), a key Foun­da­tion part­ner based at the Uni­ver­si­ty of North Car­oli­na at Chapel Hill, uses co-cre­ative strate­gies and applied tools to sup­port imple­men­ta­tion efforts. Key tools that help orga­ni­za­tions turn strat­e­gy into suc­cess­ful imple­men­ta­tion include:

• Prac­tice pro­files, which trans­late strate­gies or pro­grams into spe­cif­ic activ­i­ties, iden­ti­fy who will car­ry them out and give clear descrip­tions of what each per­son must do.
• Imple­men­ta­tion dri­vers ― such as poli­cies, pro­ce­dures, lead­er­ship, resources, coach­ing and train­ing ― that help ensure effec­tive strate­gies are imple­ment­ed well enough to achieve their intend­ed outcomes.

Rather than eval­u­at­ing a pro­gram at the end of a long peri­od of oper­a­tion, imple­men­ta­tion sci­ence involves con­stant eval­u­a­tion and mech­a­nisms for con­tin­u­ous qual­i­ty improve­ment that allow for nim­ble adjust­ments to increase effec­tive­ness more quickly.

Steps to Suc­cess will doc­u­ment process­es and activ­i­ties for key Foun­da­tion ini­tia­tives, along with sup­port­ing a set of grantees inter­est­ed in devel­op­ing imple­men­ta­tion tools that pre­pare suc­cess­ful strate­gies for larg­er pop­u­la­tions and replication.

“It can be tempt­ing to stop exam­in­ing some­thing once it seems to be work­ing,” Barnard said. ​“But under­stand­ing why and how is the key to mak­ing sure a pro­gram can work in dif­fer­ent places to make the great­est pos­si­ble difference.”

Read about imple­men­ta­tion sci­ence in The Foun­da­tion Review