Advancing the Science and Metrics on the Pace of Implementation

The persistent 17-year span between discovery and application of evidence in practice has been a rallying cry for implementation science. That frequently quoted time period often implies that implementation needs to occur faster. But what do we really know about the time required to implement new evidence-based practices into routine settings of care. Does implementation take 17 years? Is implementation too slow? Can it be accelerated? Or, does a slower pace of implementing new evidence-based innovations serve a critical function? In many cases—pandemics, health inequities, urgent social crises—pressing needs demand timely implementation of rapidly accruing evidence to reduce morbidity and mortality. Yet many central tenets of implementation, such as trust, constituent inclusion, and adaptation, take time and may require a slow pace to ensure acceptability and sustained uptake.

To date, little attention and scant data address the pace of implementation. Speed is a rarely studied or reported metric in implementation science. Few in the field can answer the question, “how long does implementation take?” Answering that question requires data on how long various implementation phases take, or how long it takes to achieve implementation outcomes such as fidelity, adoption, and sustainment. Importantly, we lack good data on how different implementation strategies may influence the amount of time to achieve given outcomes.

To advance knowledge about how long implementation takes and how long it “should optimally” take, this collection seeks to stimulate the publication of papers that can advance the measurement of implementation speed, along with the systematic study of influences on and impacts of speed across diverse contexts, to more adequately respond to emerging health crises and benefit from emerging health innovations for practice and policy. In particular, we welcome submissions on 1) methodological papers that facilitate development, specification, and reporting on metrics of speed, and 2) data-based research (descriptive or inferential) that reports on implementation speed metrics, contextual factors and/or active strategies that affect speed, or the effects of implementation speed on important outcomes in various contexts.

Areas of interest include but are not limited to:

• Data based papers documenting pace of moving through various implementation phases, and identifying factors (e.g., implementation context, process, strategies) that affect pace of implementation (e.g., accelerators and inhibitors)
• Data based papers from multi-site, including multi-national, studies comparing pace of innovation adoption, implementation, and sustainment across various contexts
• Data based papers reporting time to implementation in the face of urgent social conditions (e.g., climate change, disaster relief) Papers on how to accelerate time to delivery of treatment discoveries for specific health conditions (e.g., cancer, infectious disease, suicidality, opioid epidemic) 
• Data based papers on the timeliness of policy implementation, including factors influencing the time from data synthesis to policy recommendation, and from policy recommendation to implementation 
• Span of time needed to: achieve partner collaboration, including global health partnerships adapt interventions to make them more feasible, usable, or acceptable achieve specific implementation outcomes (e.g., adoption, fidelity, scale-up, sustainment) de-implement harmful or low-value innovations, or to identify failed implementation efforts 
• Effect of implementation pace on attainment of key outcomes such as constituent engagement, intervention acceptability or sustainability, health equity, or other evidence of clinical, community, economic, and/or policy benefits. 
• Papers addressing the interplay between pace and health equity, speed and sustainability, and other considerations that impact decision-making on implementation
• Methodological pieces that advance designs for testing speed or metrics for capturing the pace of implementation