In my column for the spring PRN Report, I briefly introduced implementation science (IS) and implementation research (IR). That short synopsis was meant to (1) clarify any muddy points regarding the rapidly developing field of IS and (2) encourage ACCP PRN members to consider applying key IS principles to their clinical pharmacy practices and, hopefully, explore opportunities to conduct valid and worthwhile IR on the important evidence-based practices, programs, and policies they are establishing or revising. Optimistically, ACCP’s official journal, Pharmacotherapy, will soon receive publishable manuscript submissions that incorporate IS!

This column now focuses on a necessary companion to IR—dissemination science. Dissemination specifically refers to the “communication of research results to specific audiences (e.g., patients, care providers, hospital leadership, policy-makers) in order for these stakeholders to make more informed decisions that ultimately lead to improved patient outcomes.”¹ One of the chief contributors to the temporal gap between generating scientifically rigorous research findings and usable research findings is the lack of a strategic and effective dissemination plan (DP). A DP is an intentional and coordinated set of activities that aims to deliver key messages to targeted audiences and stakeholders. Indeed, detailed DPs are now a requisite component of virtually all funding opportunity announcements and requests for proposals/applications from federal and private foundation funding entities. Scientific review teams and study sections critically evaluate the DP and consider it an important part of the overall merit of a proposal/application.

An effective DP has several key components. Readers are encouraged to learn about each component on their own to better understand the concepts. The Agency for Healthcare Research and Quality has produced an excellent tool to assist researchers in developing their DP.²

Developing an Effective Dissemination Strategy

Merely choosing a single journal in which to publish research findings is a necessary but insufficient mechanism for disseminating information. Indeed, developing an effective dissemination strategy is crucial because it ensures a comprehensive and efficient overall approach to disseminating research findings. Such strategies address vital elements like dissemination goals, barriers to dissemination, audiences/stakeholders for the information, and available budgeted resources. Performing this crucial step will likely yield the most value for the time and effort spent.

Leveraging Partnerships, Collaborations, and Alliances

Very rarely does any single cadre of researchers have the ability to reach all target audiences on their own. Often, therefore, investigators must collaborate with other groups to reach all of their stakeholders by a variety of media. Examples can include professional organizations (including ACCP PRNs), patient and caregiver support groups, churches and religious organizations, and other health care clinicians. Creativity and comprehensiveness in determining key partnerships are critically important.

Determining the Key Messages

Researchers must translate all of their data into cogent information that yields just a few discrete key messages. These messages must be in a comprehensible language that is appropriate for varied audiences (e.g., patients, clinicians, administrators, and policy-makers). The media through which these messages are delivered are also important. Examples include traditional journals and presentation forums, print and television media, Internet blogs, and social media forums.

Evaluating the Effectiveness of the DP

Akin to the wisdom in determining the validity of a quality improvement step is always determining whether a given DP has indeed attained its intended goals during the process or after it is carried out. One should evaluate “intermediate” outcomes, such as the proportions of target audiences who received the key messages, as well as “terminal” outcomes, like the proportion of patients who successfully received the evidence-based practice, program, or policy.

In summary, implementation researchers must strategically develop a comprehensive and effective DP for their research findings so that the findings may optimally be adopted by end users, thus ensuring that end users’ health care interventions ultimately improve patients’ health. I strongly encourage all ACCP PRN members to devote as much of their attention and effort to the sciences of dissemination and implementation as they give to developing evidence-based practices.

References:

1. Agency for Healthcare Research and Quality (AHRQ), Carpenter D, Nieva V, et al. Development of a Planning Tool to Guide Research Dissemination, 2005. Available at www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol4/Carpenter.pdf. Accessed September 20, 2016.
2. Brigham and Women’s Hospital. Biomedical Research Institute. Research Dissemination Best Practices Resource Document. From the Patient-Centered Comparative Effectiveness Research Center (PCERC). Available at www.brighamandwomens.org/Research/centers/PCERC/documents/PCERC%20Dissemination%20Best%20Practices%20Resource%20Document.pdf. Accessed September 20, 2016.