Embedding implementation science in the research pipeline

Clinical and health services researchers seek to discover effective programs, practices, and interventions to improve people's health. The current paradigm for evidence generation is incremental and misaligned to translate evidence-based discoveries into real-world settings. This persistent challenge are valleys of death that represent missed opportunities and preventable missteps to actually use scientific advancements in real-world clinical settings where they can improve health and well-being (De Geest S, Z & uacute;& ntilde;iga F, Brunkert T et al. Powering Swiss health care for the future: implementation science to bridge the valley of death. 2020;150:w20323). Only one in seven of evidence-based interventions is ever implemented. It is after an average of 17 years. We propose embedding the principles of implementation science throughout the research pipe-line, from discovery to adoption, to efficiently translate discoveries into real-world contexts (Balas EA, Boren SA. Managing clinical knowledge for health care improvement. 2000;9:65-70). We outline implications for capacity building, including composition of the research team, study design, and competencies that could bolster the value proposition of implementation science. We describe a research paradigm that recognizes scientists' responsibility to ensure their discoveries be translated into real-world settings.Lay summary Most innovative research is not used in clinical care settings. When it is, it takes a very long time to get into the real world. This means that patients may not get the best care possible to improve their health. The research community has tools that can help design innovative research in ways that it could work in clinical care settings and tools to help that happen faster, so that clinical care teams and patients can use innovative research. This is called implementation science. We outline why it is important to use implementation science ideas and teams earlier and how we can support infrastructure to do so.

Automated summary

Clinical and health services researchers aim to improve people's health by discovering effective programs, practices, and interventions. However, the current approach of evidence generation does not efficiently translate discoveries into real-world settings, resulting in missed opportunities and delays. Implementation science offers tools and principles to bridge this gap and facilitate the use of innovative research in clinical care settings, ultimately improving patient outcomes.