Knowledge translation in health: how implementation science could contribute more

Michel Wensing,Richard Grol

doi:10.1186/s12916-019-1322-9

Abstract

BackgroundDespite increasing interest in research on how to translate knowledge into practice and improve healthcare, the accumulation of scientific knowledge in this field is slow. Few substantial new insights have become available in the last decade.Main bodyVarious problems hinder development in this field. There is a frequent misfit between problems and approaches to implementation, resulting in the use of implementation strategies that do not match with the targeted problems. The proliferation of concepts, theories and frameworks for knowledge transfer – many of which are untested – has not advanced the field. Stakeholder involvement is regarded as crucial for successful knowledge implementation, but many approaches are poorly specified and unvalidated. Despite the apparent decreased appreciation of rigorous designs for effect evaluation, such as randomized trials, these should remain within the portfolio of implementation research. Outcome measures for knowledge implementation tend to be crude, but it is important to integrate patient preferences and the increased precision of knowledge.ConclusionsWe suggest that the research enterprise be redesigned in several ways to address these problems and enhance scientific progress in the interests of patients and populations. It is crucially important to establish substantial programmes of research on implementation and improvement in healthcare, and better recognize the societal and practical benefits of research.

Highlights

Despite increasing interest in research on how to translate knowledge into practice and improve healthcare, the accumulation of scientific knowledge in this field is slow
Targeted interventions to improve healthcare practice exist in most countries, and include, for instance, financial incentive programs to enhance the performance of healthcare providers, continuing professional education, and tools to involve
The growing field of research on how to improve healthcare is known under various names, such as quality improvement, implementation research, and knowledge transfer or translation [4]

Summary

Introduction

Despite increasing interest in research on how to translate knowledge into practice and improve healthcare, the accumulation of scientific knowledge in this field is slow. Decision makers in healthcare struggle with the uptake of rapidly evolving scientific knowledge into healthcare practice, organisation, and policy. Targeted interventions to improve healthcare practice exist in most countries, and include, for instance, financial incentive programs to enhance the performance of healthcare providers, continuing professional education, and tools to involve. The growing field of research on how to improve healthcare is known under various names, such as quality improvement, (dissemination and) implementation research, and knowledge transfer or translation [4]. Implementation science has been defined as the “scientific study of methods to promote the systematic uptake of research findings and other evidence-based practices into routine practice, and, to improve the quality and effectiveness of health services and care” [3]. Knowledge translation is a related field that aims to enhance

Results

Discussion

Conclusion