About The Implementation Playbook Tool
Innovations (i.e., evidence-based practices, programs, and services) can improve outcomes if they are both effective and successfully implemented. Yet, research and practice have shown us that innovations are very often not successfully implemented or adopted in a timely way.
The implementation gap is a critical issue globally. People fail to receive the best treatment and care available, provider organizations are committed but often struggle to implement and provide evidence-based care, and society misses out on returns from research investments.
Implementation is a complex process that is subject to high rates of failure and can take many years to navigate, making it costly and resource-intensive. Service providers and decision-makers need clarity on implementation methods and how to prepare and manage change. They need clear direction on what needs to be done and how to do it, what factors prepare organizations and people for change, the strategies that can alleviate barriers, and a path forward.
Implementation Science, the scientific study of methods to promote the systematic uptake of innovations, can illuminate the change pathway. But what we know about implementation is rarely communicated in a practical and efficient manner to those managing implementation in real-world settings - until now.
The Implementation Playbook© provides a solution by integrating and simplifying the implementation evidence found in multiple theories, models, and frameworks to make the process understandable, useful, and practical. With TIP, the implementation process becomes explicit, intentional, structured, and comprehensive.
Organizations frequently implement new innovations that have some degree of evidence; we refer to these as the WHAT or the innovation. The WHERE is the setting where the implementation occurs; we call this the implementation setting or implementing organization. The HOW is informed by implementation science and the context, and it is what we help you to work out using TIP.
TIP guides users through five core elements of implementation planning based on implementation science: implementation team, implementation process, determinant factors (barriers and facilitators), implementation strategies, and implementation outcomes.
Type of Innovations TIP Can Support
TIP is undergoing evaluation to determine its usability and usefulness in a range of settings and for diverse innovations. Future evaluations will explore its effectiveness and efficiencies. TIP could be useful for different types of organizations and innovations because the principles and evidence for implementation are high-level and universal. TIP may not be appropriate for innovations that are simple to put in place (plug-and-play). It is likely to be useful for multifaceted, complex innovations that have several core components (i.e., those things that must be done for the innovation to be implemented effectively and with fidelity).
Intended Users and Instructions
TIP is intended to be used by those working to implement new innovations within service provider organizations. TIP may also be useful for intermediary organizations that support implementation and for implementation researchers.
Implementation teams work through TIP together. The implementation team is formed within the implementing organization to manage the activities and processes. TIP will serve as your overall implementation plan and should be iteratively updated as you work through your implementation endeavour. Implementation planning requires the implementation team to be familiar with the core components of the innovation they are implementing.
Your team can approach implementation in an agile way. Although activities are listed in order, they are not always linear in practice; go with the flow but be mindful to return to activities you jump past.
Implementation Science Evidence
TIP is informed by several implementation theories, models, and frameworks, including the Quality Implementation Framework, the Active Implementation Frameworks, implementation strategies outlined by the Expert Recommendations for Implementing Change (ERIC) group, the Implementation Outcome Taxonomy, and the Consolidated Framework for Implementation Research (CFIR). TIP also incorporates the best evidence on equitable implementation. Equity considerations are newly emerging and sourced here from Baumann and Cabassa and Metz, Woo, and Loper. The Practice Profile is adapted from Brown, which was adapted from Blase and Duda and Blase and Fixsen. See Citations.
Funding & Acknowledgements
The Implementation Playbook (TIP) was created by implementation researchers, facilitators, and users. TIP development and evaluation is funded by a grant awarded to Melanie Barwick, CIHR Grant #PJT178129.
Citation: Barwick M. (2023). The Implementation Playbook. ON: The Hospital for Sick Children.
Other members of the research team include:
- Jacquie Brown (Jacquie Brown and Associates, Toronto, Canada)
- Kadia Petricca (Research Institute, The Hospital for Sick Children, Toronto, Canada)
- Bonnie Stevens (Research Institute, The Hospital for Sick Children, Toronto, Canada)
- Byron Powell (Center for Mental Health Services Research, Brown School, Washington University in St Louis; Division of Infectious Diseases, John T. Milliken Department of Medicine, School of Medicine, Washington University in St. Louis; Center for Dissemination & Implementation, Institute for Public Health, Washington University in St. Louis, USA)
- Alexia Jaouich (Stepped Care Solutions, Mount Pearl, Newfoundland, Canada)
- Jill Shakespeare (Centre for Addiction and Mental Health, Toronto, Canada)
- Emily Seto (Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Centre for Digital Therapeutics, Techna Institute, University Health Network, Toronto, Canada)
TIP design and development was done by Pivot Design Group.