Implementation Science Explained: What It Is, Why It Matters, and How It’s Used
By Dr. Sobia Khan, Director of Implementation
6-min read
Over the past year, we have recognized that many more people have become interested in implementation science and practice. Many new people are attending our events, signing up for our bulletin, and taking our courses. We love the interest and energy around implementation science and practice (admittedly, we are perhaps more than slightly obsessed with this field!). We also realize that because so many people are newly introduced to implementation science and practice, it might help to go back to the foundations of it all to describe what this field is all about and how it can help people in their work.
A simple definition of implementation science
Implementation science is the study and practice of how to implement things. It’s about understanding how to apply implementation strategies, processes, and approaches to support people to change and achieve outcomes. More simply, it helps us know how to implement more effectively. Implementation science is often used to capture both implementation practice and implementation research (although the field is unfortunately not always consistent in how we use any of these terms). There are even academic articles trying to unpack what implementation science is.
What is implementation practice?
Implementation practice is when we use implementation science to inform our practice (for example, using theories, models, and frameworks to help us plan for the implementation of a program; selecting strategies that have been shown to be effective for the kind of change we are hoping to create).
What is implementation research?
Another term you may have heard of is implementation research. This is the scientific study of implementation strategies, processes and approaches. People who are implementation researchers or implementation scientists are dedicated to conducting studies that generate evidence around implementation — for example, implementation researchers may be exploring what strategies work best to address certain barriers, what the best mechanisms for scale-up are, or what types of adaptations result in better outcomes in certain settings and populations.
Implementation science, practice, and research: How are they connected?
Overall, implementation science is often conceptualized as the umbrella term under which implementation research and practice reside. This is because research and practice inform the science and form a symbiotic relationship. We know a lot about how to implement because dedicated researchers have generated evidence about implementation, which can inform practice. At the same time, implementation practice can inform research because, in practice, we often use innovative strategies to get the work done and can flag real-world hurdles to pay attention to. For example, in practice, we know that implementation work cannot move forward without relationship building, so now the science of relationship building as it pertains to implementation is a focus in the field.
Where you fit: Researcher, practitioner, or both?
A key discussion that has emerged is how people identify themselves in the field of implementation science. In super simple terms, people doing research studies on implementation are implementation researchers, and those doing and supporting the implementation are implementation practitioners. But that presents a false dichotomy.
In fact, there is more of a spectrum of implementation roles than specific classifications (this paper gets into some of those roles). While it is true that some people are true implementation researchers solely dedicated to generating implementation evidence, and some people are true practitioners solely dedicated to implementing in the real world, many people find themselves in a fuzzy, hard-to-define area in between, and that’s okay. For example, many people with an implementation research role work with communities to help them apply implementation science; many people with a clinical role that involves implementation practice may also engage in implementation research.
Implementation practice or implementation support?
To add another layer of complexity, some people may also distinguish their role in terms of whether they are doing the implementation work or supporting implementation work. The difference is that if you are doing the implementation work, you are directly engaged in planning for and enacting implementation strategies, processes and approaches. People often label those doing the implementation work “implementation practitioners” or “implementers”, although people doing the work rarely refer to themselves that way. For example, health researchers often refer to individuals who provide support as "caregivers." However, these individuals might not identify with that term. Instead, they may prefer to describe themselves as a spouse, child, sibling, niece, or neighbor. Similarly, those involved in implementation work use a variety of terms to describe their roles, such as quality improvement lead, program manager, educator, or champion.
Individuals who support implementation by assisting teams of implementers in planning and executing their work — providing tools, training, or technical assistance—are often referred to as "implementation support practitioners" or "implementation specialists." While these terms are not always how they prefer to describe themselves, they are becoming increasingly common. There is also a growing body of literature on this relatively newly defined role (Albers et al., 2020) and core competencies for these roles (see Implementation Support Core Competencies and Functions and Implementation Support Practitioner Competencies). These implementation support practitioners can offer assistance at any point along the research-to-practice spectrum.
How is implementation science different from related fields?
When people are introduced to implementation science, a common reaction we have seen and heard is, “So what? How is this different from other fields?” In fact, there are many overlapping and adjacent fields — change management, quality improvement, systems change, behavioral science, and behavioral economics are just a few of them. While we could run through the similarities and differences between implementation science and all overlapping/adjacent fields, the core message is that each approach has strengths and drawbacks. We think the strength of implementation science is that there is a strong focus on understanding why and how certain strategies work at multiple levels of the system, which enables us to make better sense of implementation — why it works and why it doesn’t. Implementation science can complement other fields that focus more heavily on other things.
Implementation science vs quality improvement
For example, quality improvement has a prominent focus on improving process, and implementation science can add to this by contributing the science of strategy selection, adaptations, and implementation outcome selection. Implementation science can also draw from the best of quality improvement — for example, running small tests of change (e.g., PDSA cycles). If this is a topic you are interested in, we have posted more about the intersection and similarities between quality improvement and implementation science.
The benefits of implementation science
From our perspective, if you are interested in making an impactful change, you will likely be applying learnings from multiple fields to your work. I am a passionate implementation scientist and practitioner, and I draw on other fields regularly — like every single week, maybe even every single day. The value add that I have seen in my over 15 years of being engaged in implementation science is that people who learn the key theories, models, and frameworks of the field become a lot more strategic about how they will implement, how they will assess implementation, and how they make sense of change. It is not uncommon that people who become more competent at implementation science feel more empowered in their change work, even if they have been doing change work for many decades. The application of evidence from implementation science and other fields bolsters implementation work.
Want to learn more about implementation science?
Implementation science is about more than just putting evidence into practice or studying that process — it’s about implementing strategically, effectively, and in ways that create lasting change. Whether you identify as a researcher, practitioner, or somewhere in between, the theories, models, and frameworks from implementation science can make your work more impactful.
If you’re ready to deepen your understanding, Inspiring Change 2.0 is a great place to start — it’s our 1.5-hour free mini-course. You might also be interested in our free overview of key readings on applying implementation science. And if you’re ready to really dive in, explore our Implementation Support Specialist Certificate Program.
This article was featured in our monthly Implementation in Action bulletin! Want to receive our next issue? Subscribe here.
Related Resources
The StrategEase Pathway: A Roadmap for Designing Initiatives for Implementation (Article)
Implementation Science at a Glance (Tools/Templates/Guides)