BMJ 2019;365:l206, 10 May 2019. doi: https://doi.org/10.1136/bmj.l2068
- Analysis by Greenhalgh and Papoutsi of the challenges of disseminating innovation across the healthcare system, concludes that while it is challenging it is potentially achievable through different logics: mechanistic, ecological, and social.
- Spread (replicating an intervention) and scale-up (building infrastructure to support full scale implementation) are difficult
- Implementation science takes a structured and phased approach to developing, replicating, and evaluating an intervention in multiple sites
- Complexity science encourages a flexible and adaptive approach to change in a dynamic, self organising system
- Social science approaches consider why people act in the way they do, especially the organisational and wider social forces that shape and constrain people’s actions
- These approaches may be used in combination to tackle the challenges of spread and scale-up.
