Pushing the boundaries of Implementation Science: Can we improve care as usual?

Research Aim
So far, Implementation Science has mainly focused on implementing and de-implementing specific evidence-based interventions. However, this is not always feasible. Implementation science has not yet formulated a response to this. We believe that implementation science can provide an opportunity to improve care as usual without focussing on evidence-based interventions. Our poster will discuss a major research and development programme in the Netherlands that aims to improve care as usual in Dutch Youth Care, by implementing effective key components that are common to most forms of youth care, independent of the specific intervention or method being used.

Setting
This programme is set in Dutch Youth Care. We collaborate intensively with three youth care organisations providing a diverse array of specialised youth care, for example to children in residential care or foster care, families in high conflict divorce, or children and families struggling with a variety of psychiatric problems.

Methods
The programme consists of multiple steps, based on the Active Implementation Framework. The first step is to turn the effective key components (e.g., shared decision making) into usable interventions, using practice profiles. Using a design-oriented approach, the next steps are to develop learning interventions for professionals to learn these key components, and to develop implementation strategies to ensure sustainability of the learning interventions. We use a mixed-method approach to monitor changes in the organisations over time, and a single-case study design to evaluate effectiveness of the learning interventions. We are currently working on step 1.

Key Insights
• We believe our approach can be a promising solution to the current limitations of implementation science, which focusses on implementation of interventions only.

• We will show how common components can be developed into usable interventions, thereby framing care as usual into terminology and formats that are usable within implementation science.