Dataset Information

Rugged landscapes: complexity and implementation science.

ABSTRACT:

Background

Mis-implementation-defined as failure to successfully implement and continue evidence-based programs-is widespread in public health practice. Yet the causes of this phenomenon are poorly understood.

Methods

We develop an agent-based computational model to explore how complexity hinders effective implementation. The model is adapted from the evolutionary biology literature and incorporates three distinct complexities faced in public health practice: dimensionality, ruggedness, and context-specificity. Agents in the model attempt to solve problems using one of three approaches-Plan-Do-Study-Act (PDSA), evidence-based interventions (EBIs), and evidence-based decision-making (EBDM).

Results

The model demonstrates that the most effective approach to implementation and quality improvement depends on the underlying nature of the problem. Rugged problems are best approached with a combination of PDSA and EBI. Context-specific problems are best approached with EBDM.

Conclusions

The model's results emphasize the importance of adapting one's approach to the characteristics of the problem at hand. Evidence-based decision-making (EBDM), which combines evidence from multiple independent sources with on-the-ground local knowledge, is a particularly potent strategy for implementation and quality improvement.

SUBMITTER: Ornstein JT

PROVIDER: S-EPMC7523395 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Publications

Rugged landscapes: complexity and implementation science.

Ornstein Joseph T JT Hammond Ross A RA Padek Margaret M Mazzucca Stephanie S Brownson Ross C RC

Implementation science : IS 20200929 1

<h4>Background</h4>Mis-implementation-defined as failure to successfully implement and continue evidence-based programs-is widespread in public health practice. Yet the causes of this phenomenon are poorly understood.<h4>Methods</h4>We develop an agent-based computational model to explore how complexity hinders effective implementation. The model is adapted from the evolutionary biology literature and incorporates three distinct complexities faced in public health practice: dimensionality, rugge ...[more]

PMID: 32993756

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Dataset Information

Rugged landscapes: complexity and implementation science.

Background

Methods

Results

Conclusions

Publications

Rugged landscapes: complexity and implementation science.

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