Implementation has been shown to have a greater chance of success if it fits with the changing needs and priorities of the system into which it is being introduced. To understand how it fits, we need to find out how implementing the project output will address current gaps in health and social care delivery and provision. There are a number of ways to assess fit. For example, examining published research conducted in the field by undertaking a review of existing literature and policy documentation. If you do not have access to library resources, you may need to collaborate with academic colleagues to help with this. Another option is through informal conversations with colleagues, managers and commissioners who may be able to offer you first-hand knowledge of what is missing and how they see your plans for implementation addressing any gaps.
Take time to consider and investigate if implementation is locally relevant and actionable and gather any evidence to support this. For any new policy or change to practice it is likely that there will need to be guidelines, policies and documents to outline processes. Also consult with your team and local networks to gather their views and perspectives on how implementation may fit with these guidelines and processes.
Think about who will be involved in driving implementation. This may be more than one individual. Consider the knowledge, skills and insights needed to lead implementation. Will they need to be internal to and working within an organisation and/or external to the organisation and how will they work with others to lead implementation? Consider what incentives there may be for their involvement in implementation. For example, will this potentially benefit professional development or relational working with others.
It is important to take into account how implementation will fit with current ways of working within organisation(s). This includes whether implementation will require changes to professional roles, responsibilities and pathways, current workloads and how it may affect how people work together within and across organisations. Implementation is more likely to be successful if it does not create additional work or duplicate existing practices. Consultation with key stakeholders will be essential to understand the potential impact of implementation on current ways of working.
Take time to consider if implementation may compete with other implementation/improvement work which is currently, or has recently, taken place within the organisation. For example, consulting with stakeholders as well as local networks may help you identify if similar initiatives have been adopted recently.
It is usual that when an innovation or changes to current practice and ways of working are introduced there will be an impact on the system in which it is adopted. Think about how you might identify potential impact (positive and negative) as well as how you will assess impact. For example, you may collaborate with academic colleagues to conduct an evaluation. The evaluation will enable you to identify the extent to which implementation has brought about change for individuals, organisations and the wider health and social care system.
Challenges may arise as a result of implementation. Such challenges might include creating additional work for those involved or not having enough time or resources to support implementation. Consulting with local stakeholders, networks and public contributors at the beginning and throughout your project, can help to identify and mitigate these. There may also be unanticipated challenges which arise during implementation. Again, consulting with local stakeholders, networks and public contributors can be helpful in considering what actions may need to be taken to address these.
Supporting implementation requires resources. Resources can range from training, education to engage, practical responses, communication strategies and dissemination resources. Consider what resources will be needed to support implementation as well as who will need to be responsible for these and their capacity to support. Think about how long resources may be required and whether there are any cost associations.
Think about the potential value or benefit of implementation to different stakeholders and to the wider health and social care systems. Consulting with stakeholders, networks, and public contributors at the beginning and throughout your project can help establish what value implementation may bring, as well as if this value is likely to change. Consider how the wider social, economic and political context may also shape these values.
“We took time to understand how the aims of our project related to local and national policy and research on improving awareness of Parkinson’s disease in the community. We also spoke to other people within our local networks about their awareness of projects relating to the topic. Because of this, early on we realised there was a project with similar aims being undertaken by another local organisation. Though this was a challenge, as we had taken time to speak to people within our local networks, we had the opportunity to consider whether our project would be able to offer something different. We realised that though the projects had similar aims they were involving different stakeholder groups. We were also able to attend learning events from the other project to understand which steps may be helpful to repeat and avoid in our own project. This was invaluable as it saved both time and resources of those involved. It also ensured that our project fitted with local and national aims and provided something of real benefit and value to our local community.”