An introduction to implementation science in rehabilitation medicine

康复医学实施科学导论

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Abstract

The fundamental goal of research that develops and tests rehabilitation interventions is to improve the health, function, and quality of life of patients with disabling health conditions. Rehabilitation medicine frequently uses multicomponent interventions delivered by multidisciplinary teams. This care may also occur over time across a continuum of care (eg, acute care, postacute care, outpatient clinics). Thus, research-developed rehabilitation interventions may be challenging to implement and sustain in routine care settings, particularly for disabling health conditions that persist over time. The field of implementation science has emerged in direct response to these challenges by supporting more rapid, consistent implementation of evidence-based practices in routine care through carefully designed, systematic implementation efforts. Implementation science aims to elucidate the factors that influence implementation success (ie, barriers and facilitators), to identify and evaluate implementation strategies likely to facilitate successful implementation, and to study the underlying mechanisms through which implementation strategies produce their effects on implementation outcomes. This article introduces the field of implementation science and provides an overview of the PM&R special issue on implementation science. The article presents core implementation science concepts and approaches and discusses their application to specific evidence-based rehabilitation interventions that are underused in treating disabling health conditions. The successful application of implementation science methods offers the promise of improved adoption of evidence-based rehabilitation practices to optimize patient outcomes and help maximize realization of their societal value and benefits.

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