Improvement Science and Implementation Science in Cancer Care: Identifying Areas of Synergy and Opportunities for Furthe
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Department of Population Health Sciences and Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA; 2Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC, USA; 3Oregon Rural Practice-based Research Network and Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA; 4School of Public Health, Oregon Health & Science University and Portland State University, Portland, OR, USA; 5The VA Outcomes Group, White River Junction VA Medical Center, Hartford, VT, USA; 6The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, Hanover, NH, USA; 7 Department of Surgery – Otolaryngology Head & Neck Surgery, Geisel School of Medicine at Dartmouth, Hanover, NH, USA; 8Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA; 9Fox Chase Cancer Center, Philadelphia, PA, USA; 10Duke University Medical Center Library & Archives, Duke University School of Medicine, Durham, NC, USA; 11The Brown School at Washington University in St. Louis, St. Louis, MO, USA; 12Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA; 13 Section of Urology and Norris Cotton Cancer Center, Dartmouth Hitchcock Medical Center, Lebanon, PA, USA; 14Department of Health Policy and Management, Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; 15Flinders University, Adelaide, Australia.
Efforts to improve cancer care primarily come from two fields: improvement science and implementation science. The two fields have developed independently, yet they have potential for synergy. Leveraging that synergy to enhance alignment could both reduce duplication and, more importantly, enhance the potential of both fields to improve care. To better understand potential for alignment, we examined 20 highly cited cancer-related improvement science and implementation science studies published in the past 5 years, characterizing and comparing their objectives, methods, and approaches to practice change. We categorized studies as improvement science or implementation science based on authors’ descriptions when possible; otherwise, we categorized studies as improvement science if they evaluated efforts to improve the quality, value, or safety of care, or implementation science if they evaluated efforts to promote the implementation of evidence-based interventions into practice. All implementation studies (10/10) and most improvement science studies (6/10) sought to improve uptake of evidencebased interventions. Improvement science and implementation science studies employed similar approaches to change practice. For example, training was employed in 8/10 implementation science studies and 4/10 improvement science studies. However, improvement science and implementation science studies used different terminology to describe similar concepts and emph
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