Brooks Stephanie P, Alba Cody, Montesanti Stephanie, Thomson Denise, Davison Sara N, Graham Kathryn, Storey Kate
Learning Health System Team, Alberta SPOR SUPPORT Unit, Department of Medicine, University of Alberta, Edmonton Clinic Health Academy, 11405 87 Ave NW, Edmonton, AB, T6G 1C9, Canada.
School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405-87 Ave NW, Edmonton, Alberta, T6G 1C9, Canada.
Implement Sci Commun. 2025 Aug 2;6(1):80. doi: 10.1186/s43058-025-00765-2.
Implementation science as a field is rapidly advancing. Moreover, implementation science plays a pivotal role in driving learning health systems to better realize health outcomes and impact for our communities. Yet, few reports detail the infrastructures that underpin embedding and managing implementation science activities. Furthermore, there is little guidance for designing these infrastructures (people-powered and/or inanimate supports essential for embedding implementation research questions in pilot, spread and scale initiatives) to address local research and practice needs. The Implementation Science Collaborative is one such infrastructure in Alberta, Canada that leverages existing expertise in implementation research and practice to facilitate embedded implementation research and increase the success rates of health innovation implementation for better health outcomes. This study sought to provide actionable recommendations for designing effective implementation infrastructure by examining the co-design of the Implementation Science Collaborative.
We conducted a longitudinal case study (2018-2021) of the Implementation Science Collaborative using document analysis and semi-structured interviews. We collected data from initiative planning and operations documents (n = 190) and semi-structured interviews with Implementation Science Collaborative members (n = 6). We applied the Large-Scale Change Driver Model as the analytical framework for qualitative analysis to generate insights into designing cross-sectoral implementation science infrastructure.
Our analysis showed that infrastructure design and operationalization followed established principles of implementation planning and execution. Implementation intermediaries proved to be effective facilitators as they had the backgrounds required to guide co-design and implementation planning. Their political neutrality in the resulting infrastructure enabled them to address power imbalances among co-design partners. However, strong management leadership remained irreplaceable. Cross-sectoral leadership was essential in fostering and solidifying the partnerships required for supporting the local learning health system.
The study findings highlight the effectiveness of a co-design approach, facilitated by intermediaries, in developing local implementation science infrastructure and management systems as a promising practice to implement for achieving outcomes. This approach enabled the creation of infrastructure designs that meet diverse user needs. However, co-design is a complex process that benefits from both intermediaries' skills and cross-sectoral leadership knowledge of the local learning health system.
实施科学作为一个领域正在迅速发展。此外，实施科学在推动学习型健康系统以更好地实现健康成果并对我们的社区产生影响方面发挥着关键作用。然而，很少有报告详细介绍支撑实施科学活动的嵌入和管理的基础设施。此外，在设计这些基础设施（将实施研究问题嵌入试点、推广和扩大举措中必不可少的人力和/或无生命支持）以满足当地研究和实践需求方面，几乎没有指导。实施科学协作组织是加拿大艾伯塔省的这样一个基础设施，它利用实施研究和实践方面的现有专业知识来促进嵌入式实施研究，并提高健康创新实施的成功率以实现更好的健康成果。本研究旨在通过考察实施科学协作组织的共同设计，为设计有效的实施基础设施提供可行的建议。
我们使用文档分析和半结构化访谈对实施科学协作组织进行了一项纵向案例研究（2018 - 2021年）。我们从倡议规划和运营文档（n = 190）以及与实施科学协作组织成员的半结构化访谈（n = 6）中收集数据。我们应用大规模变革驱动因素模型作为定性分析的分析框架，以深入了解跨部门实施科学基础设施的设计。
我们的分析表明，基础设施设计和运作遵循既定的实施规划和执行原则。实施中介被证明是有效的促进者，因为他们具备指导共同设计和实施规划所需的背景。他们在由此产生的基础设施中的政治中立性使他们能够解决共同设计伙伴之间的权力不平衡问题。然而，强大的管理领导力仍然不可替代。跨部门领导力对于培养和巩固支持当地学习型健康系统所需的伙伴关系至关重要。
研究结果强调了在中介促进下的共同设计方法在开发当地实施科学基础设施和管理系统方面的有效性，这是一种有望实现成果的实施实践。这种方法能够创建满足不同用户需求的基础设施设计。然而，共同设计是一个复杂的过程，受益于中介的技能和当地学习型健康系统的跨部门领导知识。
