The Bottom Line: Specifying and comparing implementation strategies

Cynthia Perry, PhD, FNP-BC, FAHA, ESCALATES Co-Investigator


Implementation strategies are the methods used to help organizations, such as primary care practices, make the changes they need in order to implement evidence into practice and improve quality. The Expert Recommendations for Implementing Change(1) is a taxonomy that provides common names, definitions, and categorization of a broad range of implementation strategies. These strategies have been developed through input by experts. To date, few have looked to see how the ERIC strategies compare with the ones actually used in large scale dissemination and implementation initiatives such as EvidenceNOW. That is what we did in this study.

Useful Finding

One of the common implementation strategies utilized across EvidenceNOW Cooperatives was practice facilitation. Practice facilitation is an approach to support improvement in primary care practices. In EvidenceNOW, practice facilitators were employed by all of the Cooperatives to support quality improvement.

Practice facilitators used a number of the implementation strategies identified in the ERIC taxonomy. In fact, they used thirty-three different implementation strategies. This highlights the complexity of facilitation and the critical role facilitators play when implementing evidence into practice and building capacity for quality improvement.  Our work also shows how ERIC strategies are interconnected to accomplish functions that are important for quality improvement. For instance, multiple implementation strategies (e.g. use of data experts, use of data warehousing techniques, development and implementation tools for quality monitoring) were needed to achieve data informed quality improvement, what is termed “audit and feedback” in the ERIC taxonomy. In addition, we suggested a few minor additions and tweaks to the ERIC taxonomy.

The Bottom Line

The findings of our study can guide implementers’ work as they choose among ERIC strategies to employ when supporting quality improvement. Our work helps implementers recognize that certain implementation strategies need to be linked to accomplish larger functions, such as audit and feedback.

In addition, our work contributes to the implementation science field by testing and offering refinements to the ERIC taxonomy based on real-world, on-the-ground implementation in  primary care.

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lessons from applying implementation strategy theory to the real world

1. Powell BJ, Waltz TJ, Chinman MJ, Damschroder LJ, Smith JL, Matthieu MM, et al. A refined compilation of implementation strategies: results from the Expert Recommendations for Implementing Change (ERIC) project. Implement Sci. 2015;10:21.

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