Commentary on: “The clinician crowdsourcing challenge: using participatory design to seed implementation strategies”

Jul 29,2019 | AKirk Featured Articles

In their recent publication, Stewart et al. highlight an issue that implementation scientists face daily—that those in leadership or management positions are usually the ones steering the ship, but frontline workers are usually the ones who are asked to change their behavior. The authors tackle this issue in an innovative and approachable way: through an “innovation tournament.” Through the tournament, a wide swath of clinicians were emailed and asked to submit ideas about how organizations could support clinician use of evidence-based practices (EBPs) via an online platform. The platform was interactive and included features that allowed clinicians to comment on and rank the ideas of their peers. From there, a panel of researchers, administrators, and clinicians ranked the best ideas and finalists were invited to a working lunch to refine their ideas so that they could pitch them at an “idea gala.” All participants were invited to the gala (not just the winners!) to hear about the selected ideas and were asked to rate the ideas that excited them the most.

When selecting an article to feature in this month’s newsletter, this piece stuck out to me for a couple of reasons. First, the “tournament” is an example of participatory approaches done right. If we think about a model like IAP2’s spectrum of public participation, too often we include voices through informing or consulting where we listen to and acknowledge others’ concerns and aspirations, but only after we as scientists have scoped the problem and designed potential solutions. By partnering with clinicians in the development of potential solutions and identification of preferred solutions, the tournament provides a great example of collaboration and empowerment that truly puts clinicians in the driver’s seat. As noted by the authors, opportunities that allow for meaningful collaboration and empowerment have the potential to carry the added benefit of increasing buy-in early on, which can set organizations up for successful implementation.

Beyond the science of the work, however, I think what drew me to the article is the point I want to conclude with. The authors managed to create a vehicle for getting public input that was fun, and it was this aspect of fun that got me excited about the article and motivated to write this commentary. As scientists, I think we often forget to have fun. However, as implementation scientists, the value of fun is something we would do well to keep at the forefront of our work. As implementation scientists, we seek to change the behavior of people and organizations, and I think we too often forget that a great way to foster positive change is to make it fun. This paper went beyond the traditional focus group or expert panel and gathered information from the target audience in a way that met their scientific objectives (i.e., was effective at gathering the needed information) but that was also empowering and fun. Although the authors didn’t rate the “fun-ness” of the tournament itself, they did integrate this notion of excitement and its relationship to motivation through their ranking system. Clinicians were asked to rank ideas not on a typical implementation outcome like feasibility or cost; instead, they were asked to rank ideas on how excited they were about it.

Thus, as we all go out into our daily jobs, I would encourage us to keep this question in the forefront of our mind: how excited am I about this idea? After all, if we can’t get excited about an implementation strategy, how well do we think it will motivate someone else to change their behavior?

Read the full abstract.