Title

Shifting Implementation Science Theory to Empower Primary Care Practices.

Publication/Presentation Date

5-1-2019

Abstract

Observers of the past 10 to 15 years have witnessed the simultaneous growth of dramatic changes in the practice of primary care and the emergence of a new field of dissemination and implementation science (D&I). Most current implementation science research in primary care assumes practices are not meeting externally derived standards and need external support to meet these demands. After a decade of initiatives, many stakeholders now question the return on their investments. Overall improvements in quality metrics, utilization cost savings, and patient experience have been less than anticipated. While recently conducting a research project in primary care practices, we unexpectedly discovered 3 practices that profoundly shifted our thinking about the sources and directionality of practice change and the underlying assumptions of D&I. Inspired by these practices-along with systems thinking, complexity theory, action research, and the collaborative approaches of community-based participatory research-we propose a reimagining of D&I theory to empower practices. We shift the emphasis regarding the source and direction of change from

Volume

17

Issue

3

First Page

250

Last Page

256

ISSN

1544-1717

Disciplines

Family Medicine

PubMedID

31085529

Department(s)

Department of Family Medicine, Department of Family Medicine Faculty

Document Type

Article

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