Commentary on “Engaging Operational Partners Is Critical for Successful Implementation of Research Products: a Coincidence Analysis of Access-Related Projects in the Veterans Affairs Healthcare System”
The implementation and sustainment of evidence-based interventions (e.g., programs, tools) in clinical practice necessitates that these interventions align with the healthcare system’s priorities and clinical workflow. One way to help ensure alignment with the health system is to involve key informants who have institutional knowledge and decision-making authority for activities within the healthcare system. Key informants lead or represent program offices (e.g., VHA Office of Rural Health, VHA Office of Connected Care), hospital departments or divisions (e.g., Department of General Internal Medicine, Division of Geriatrics), hospital units (e.g., Surgical Intensive Care, Medical-Surgical) and are knowledgeable on staffing, clinical workflow, policies and procedures, and barriers and facilitators to clinical activities. Key informants have essential awareness of what is going on in their part of the healthcare system and how they fit within the healthcare system. This institutional knowledge is critical for researchers and practitioners who aim to develop, implement, sustain, and disseminate real-world evidence-based interventions.
A recent article by Dodge et al, explores the importance of engaging operations partners in implementation of evidence-based interventions to increase access for Veterans in the community setting. This manuscript reviewed a research portfolio of VHA-funded projects focused on improving access to care for Veterans. Dodge et al identified 36 projects that had implementable research deliverables (e.g., effective interventions or usable tools). The authors then surveyed the principal investigator or project lead from the 36 projects identified. The survey assessed the implementation status of each project as well as the barriers and facilitators to implementation. Results indicated that most investigators reported having sufficient resources, information technology support, local operational leadership support, and the presences of a local champion. Barriers included constraints on time, expertise, or resources; changes in the environment; and not having engagement with operational leadership at the local or regional level. A coincidence analysis indicated that out of 14 possible barriers and facilitators, two were critical ‘difference makers’ that led to partial or full implementation of project deliverables: engagement with national VHA operational leadership and support and commitment from local site operational leadership. One impactful finding is the importance of engaging operational partners as this engagement can lead to successful implementation, and sustainment, of research deliverables.
Key informants have institutional awareness that is essential for moving implementation science forward in healthcare delivery systems. The implication of Dodge et al’s research is the importance of engaging key informants, early and often, in the implementation of evidence-based interventions. Further research by implementation scientists in collaboration with key informants as intentional partners in research, can help promote the uptake and adoption of clinically relevant interventions that are prime for dissemination.
References:
Dodge, J. R., Youles, B., Caldararo, J., Sears, E. D., Caverly, T. J., Michael Ho, P., Adams, M. A. (2023). Engaging Operational Partners Is Critical for Successful Implementation of Research Products: a Coincidence Analysis of Access-Related Projects in the Veterans Affairs Healthcare System. J Gen Intern Med. doi:10.1007/s11606-023-08115-5