Coronavirus (COVID-19) update

IMPLEMENT@Bangor
Implementation Research Programme

Impact

Traditionally researchers have relied on publications at the end of studies to disseminate research findings. Implementation recognises that this approach has only limited success. Whilst we ensure that our research is actively disseminated through publications, conference presentations and other social media, we work with health care managers, clinical leaders and others to explore new ways of ensuring impact.

Some examples of how we approach impact are shown below.

Partnership Project Work

Our research partnerships are not confined to health care. New alliances with other public service providers are enabling us to find new ways to tackle different types of implementation challenges, and broaden the potential for impact.

IMPLEMENT@Bangor is collaborating with North Wales Police and the National Policing Improvement Agency to increase the use of evidence about effective policing solutions to anti-social behaviour across North Wales. The collaboration provides an excellent opportunity to share experience and expertise in tackling the challenge of implementing evidence of ‘what works’ across the health and policing services.

The collaboration is focusing on the use of the Promoting Action on Research Implementation in Health Services (PARIHS) framework, developed by IMPLEMENT@Bangor co-Director Professor Rycroft Malone. PARIHS asserts that for the implementation of evidence to be successful, synergy between the nature of evidence, the organisational contexts in which its implementation is planned, and the facilitation strategies designed to promote evidence use is required. Importantly, the collaboration will test the transferability of PARIHS to new policy arenas which have similar responsibilities for ensuring the effective and efficient use of public resources through using research evidence in service planning and delivery.

IMPLEMENT@Bangor is currently leading a survey of the North Wales Police workforce which will provide a theory-led overview of the nature of the implementation context for research implementation in policing. Work with our partners will ensure that appropriate implementation interventions are designed to promote the use of effective solutions to anti-social behaviour.

Models, tools and activities

Promoting Action on Research Implementation in Health Services (PARIHS) Framework

Jo Rycroft-Malone

This body of work has influenced the framing and conduct of implementation research and knowledge translation nationally and internationally. PARIHS is providing a guide to understanding implementation readiness, how to organise activity to increase the use of evidence in practice, policy and service delivery, and in the evaluation of such activity. PARIHS has found its way into a variety of settings and agencies in the form of consultancies, service delivery and organisation, policy and partnership research and exchange.


The Promoting Action on Research Implementation in Health Services (PARIHS) framework was developed inductively and has been subsequently refined over time. Successful implementation is represented as a function of the nature of evidence, the quality of the context of implementation, and appropriate approaches to facilitation: SI = f(E,C,F).

Click here to view the slideshow: 'What PARIHS is about'

PHASE
ACTIVITIES AND RELATED PUBLICATIONS

Development

  • Retrospective and theoretical analysis of four case studies.

Concept analysis

  • Undertaken on the 3 core concepts of PARIHS: Evidence, Context and Facilitation using Morses’ concept analysis approach (1996). £20,000 RAE internal grant income.
  • Rycroft-Malone, Kitson, Harvey, McCormack, Seers, Titchen, & Estabrooks (2002) Ingredients for change: Revisiting a conceptual framework, Quality and Safety in Health Care, 11, 174 – 180
  • Harvey, Loftus-Hills, Rycroft-Malone, Titchen, Kitson, McCormack & Seers Getting evidence into practice: the role and function of facilitation (2002), Journal of Advanced Nursing, 37(6), 577 – 588
  • McCormack, Kitson, Harvey, Rycroft-Malone, Titchen, Seers (2002) Getting evidence into practice - the meaning of ‘context’, Journal of Advanced Nursing, 38(1), 94 – 104.
  • Rycroft-Malone, Seers, Titchen, Kitson, Harvey, McCormack (2004) What counts as evidence in evidence based practice? Journal of Advanced Nursing, 47(1), 81-90

Empirical enquiry

  • Case studies of evidence into practice projects to check out the content validity of PARIHS.
  • Rycroft-Malone, Harvey, Seers, Kitson, McCormack, & Titchen (2004) An exploration of the factors that influence the implementation of evidence into practice Journal of Clinical Nursing, 13, 913-924.

Empirical testing

  • Evaluating the impact of different types of facilitation (enabling and technical) on the implementation of recommendations for continence care: A process and outcome evaluation.
  • Funded by European Union Framework 7 involving centres in the UK and NI, Ireland, Sweden and the Netherlands. 2009 – 2013; 3 million Euros


    FIRE (Facilitating Implementation of Research Evidence): a study protocol
    Kate Seers, Karen Cox, Nicola J Crichton, Rhiannon TUDOR Edwards, Ann CATRINE Eldh, Carole A Estabrooks, Gill Harvey, Claire Hawkes, Alison Kitson, Pat Linck, Geraldine McCarthy, Brendan McCormack, Carole Mockford, Jo Rycroft-Malone, Angie Titchen and Lars Wallin Implementation Science 2012, 7:25

Development of tools

  • Development of diagnostic and evaluative tools for use in research and practice.
  • Development of facilitation toolkits.
  • Some initial items for tools can be found in Kitson, Rycroft-Malone, Harvey, McCormack, Seers, Titchen (2008). Evaluating the successful implementation of evidence into practice using the PARIHS framework: theoretical and practical challenges. Implementation Science3:1

Impact of publications

The Google Scholar citations for the following papers range from 295 to 118. The 2008 Implementation Science paper has been consistently in the top 10 most accessed papers for the Journal, having been accessed over 21,000 times.

Citations have been matched against the papers listed below. Many of the citations go beyond ‘referencing’ and include empirical studies that have applied the PARIHS framework – e.g. in the evaluation and implementation of interventions, and to assess the success and challenges associated with implementation.

Key papers

  • Kitson A, Rycroft-Malone J, Harvey G, McCormack B, Seers K, Titchen A (2008) Evaluating the successful implementation of evidence into practice using the PARIHS framework: Theoretical and practical challenges, Implementation Science, 3(1), 7th January 2008 (157 citations, accessed over 21,000 times)
  • Rycroft-Malone J, Harvey G, Seers K, Kitson A. McCormack B, & Titchen A. (2004) An exploration of the factors that influence the implementation of evidence into practice. Journal of Clinical Nursing, 13, 913-924 (265 citations)
  • Rycroft-Malone J, Seers K, Titchen A, Harvey G, Kitson A, McCormack B (2004) What counts as evidence in evidence-based practice? Journal of Advanced Nursing, 47(1): 81-90 (330 citations)
  • Rycroft-Malone J. (2004) The PARIHS framework – A framework for guiding the implementation of evidence-based practice. Journal of Nursing Care Quality, 19(4), 297-304. (158 citations)
  • Harvey G, Loftus-Hills A, Rycroft-Malone J, Titchen A, Kitson A, McCormack B, Seers K (2002) Getting evidence into practice: the role and function of facilitation. Journal of Advanced Nursing, 37(6): 577-588 (271 citations)
  • McCormack B, Kitson A, Harvey G, Rycroft-Malone J, Titchen A, Seers K (2002) Getting evidence into practice: the meaning of context. Journal of Advanced Nursing, 38(1): 94-104 (337 citations).
  • Rycroft-Malone J, Kitson A, Harvey G, McCormack B, Seers K, Titchen A, Estabrooks C (2002) Ingredients for change: revisiting a conceptual framework. Quality in Healthcare, 11(2): 174-180. (339 citations)


Key users and beneficiaries - examples

North Wales Police and National Police Improvement Agency. Approached by the NPIA and North Wales Police to collaborate on the application of PARIHS to progress effective policing practice.


Veterans Administration – US – QUERI programme – used the PARIHS framework as part of the organisation’s approach to facilitating and evaluating quality improvement – e.g. A Guide for applying a revised version of the PARIHS framework for implementation Cheryl B Stetler, Laura J Damschroder, Christian D Helfrich, Hildi J Hagedorn Implementation Science 2011, 6:99


Service delivery & practice development - Used in the Greater Manchester CLAHRC – evidence in their documentation as the framework of choice for organising their implementation activity.