Promoting Action on Research Implementation in Health Services: the Integrated-PARIHS framework

We did not specifically set out to produce an implementation framework.
It developed more organically from our accumulated experiences of trying
to apply research into practice. In the mid-1990s, we were working with
colleagues at the Royal College of Nursing (RCN) Institute in Oxford
in the United Kingdom (UK). This was a research and development
unit with a strong focus on applied research and supporting change
and improvement in practice, utilizing a range of different approaches
such as quality improvement, clinical guidelines, clinical audit, practice
development and clinical leadership development. During this same time
period, evidence-based practice was very much in the ascendancy, and within the United Kingdom there was increasing policy interest in the so called translation gaps between research, clinical practice, and patient and population outcomes. This resulted in more explicit and concerted efforts to accelerate the implementation of research evidence into clinical practice and health service delivery. However, the predominant mental model of translation was that of a pipeline, a linear process that typically involved key stages of research production and synthesis (for example, systematic reviews and clinical guidelines), followed by dissemination, education of clinical staff to increase knowledge and awareness of the evidence, and clinical audit to monitor uptake and feedback on progress.