Developing a theory-based taxonomy of methods for implementing change in practice.

Area of Science:

• Healthcare implementation science
• Nursing practice research
• Health services research

Background:

• Implementation research faces challenges with inconsistent terminology and varying method relevance across disciplines.
• Studies on implementation effectiveness show mixed and often small positive effects.
• A lack of a guiding framework may contribute to the limited success of practice change initiatives.

Purpose of the Study:

• To develop a theory-based taxonomy of methods used for implementing practice changes.
• To address the inconsistent terminology and lack of a guiding framework in implementation research.
• To create a clear and mutually exclusive guide for implementation methods in nursing.

Main Methods:

• A provisional taxonomy of implementation methods was developed from theory and existing taxonomies.
• A content analysis was performed on 43 reports of empirical studies of practice changes in nursing (1995-2005).
• The taxonomy was iteratively revised during the analysis to enhance its comprehensiveness.

Main Results:

• The final taxonomy includes 14 implementation methods, categorized into five groups: increasing coordination, raising awareness, persuasion (interpersonal and belief-based), and increasing behavioral control.
• Nine methods from the provisional taxonomy were retained, two were removed, and five new methods were identified.
• The taxonomy provides a structured classification of implementation strategies.

Conclusions:

• The developed taxonomy is specific to nursing and offers a clear, mutually exclusive classification of implementation methods.
• Linking methods to theoretical constructs can inform the selection of strategies across diverse practice changes and settings.
• This framework aims to improve the consistency and effectiveness of implementation research and practice.