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Methodology Issues in Implementation Science

Newhouse, Robin PhD, RN, NEA-BC, FAAN*; Bobay, Kathleen PhD, RN, NEA-BC; Dykes, Patricia C. DNSc, RN, FAAN, FACMI; Stevens, Kathleen R. EdD, RN, ANEF, FAAN§; Titler, Marita PhD, RN, FAAN

doi: 10.1097/MLR.0b013e31827feeca
Original Articles

Background: Putting evidence into practice at the point of care delivery requires an understanding of implementation strategies that work, in what context and how.

Objective: To identify methodological issues in implementation science using 4 studies as cases and make recommendations for further methods development.

Research Design: Four cases are presented and methodological issues identified. For each issue raised, evidence on the state of the science is described.

Results: Issues in implementation science identified include diverse conceptual frameworks, potential weaknesses in pragmatic study designs, and the paucity of standard concepts and measurement.

Conclusions: Recommendations to advance methods in implementation include developing a core set of implementation concepts and metrics, generating standards for implementation methods including pragmatic trials, mixed methods designs, complex interventions and measurement, and endorsing reporting standards for implementation studies.

*Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD

Marquette University College of Nursing, Milwaukee, WI

Brigham and Women’s Hospital, Center for Patient Safety Research and Practice, Center for Nursing Excellence, Boston, MA

§Academic Center for Evidence-Based Practice, University of Texas Health Science Center San Antonio, San Antonio, TX

Division of Nursing Business & Health Systems, Office of Practice and Clinical Scholarship, University of Michigan School of Nursing, Ann Arbor, MI

The authors declare no conflict of interest.

Supported by Robert Wood Johnson Foundation (RWJF) Interdisciplinary Nursing Quality Research Initiative (INQRI).

Reprints: Robin Newhouse, PhD, RN, NEA-BC, FAAN, Organizational Systems and Adult Health, University of Maryland School of Nursing, 655 West Lombard Street, Suite 316, Baltimore, MD 21201. E-mail:

© 2013 Lippincott Williams & Wilkins, Inc.