Implementation during a time of crisis: The critical role of trusting relationships

By Allison Metz

author-alison-metz
Allison Metz (biography)

Are there lessons we can learn from the current response of service systems which have galvanized into action to meet the needs of children and families during the COVID-19 pandemic? How does the response of service systems affect our hypotheses about how change happens at scale?

In my professional role providing implementation support to public service systems, I’ve observed these systems responding to the COVID-19 pandemic with urgency and agility. The urgency is to be expected, but the agility has inspired me.

The agility runs counter to accepted wisdom in implementation science that implementation takes time. Depending on the scope and complexity of the change effort, it can take up to five years for initiatives to reach full implementation.

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Improving mutual consultation among key stakeholders to optimize the use of research evidence

By Allison Metz

Alison Metz
Allison Metz (biography)

Processes to support the uptake of research evidence call for each of the key stakeholders to consider the challenges faced by other key stakeholders in making good use of research evidence. When stakeholders have the opportunity to consider perspectives other than their own, they will generally have a broader understanding of the problem space, and, in turn a greater commitment to co-creating prototypes for improving research translation.

Let’s consider a real world example in New York City’s public child welfare system.

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Where are the stakeholders in implementation science?

By Allison Metz and Annette Boaz

authors_allison-metz_annette-boaz
1. Allison Metz (biography)
2. Annette Boaz (biography)

Should implementation science make more room for consultation, collaboration and co-creation with stakeholders? Would finding more active roles for stakeholders in implementation science be a promising approach to increasing the use of research evidence for improvements in policy and services?

The goal of implementation science is to promote the sustainable implementation of research evidence at scale to improve population outcomes, especially in health and human services. Nevertheless, the mobilization of research evidence on the frontlines of health and human services has been quite limited, especially in public agencies serving the vast majority of consumers.

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The promise of using similar methods across disciplines

By Allison Metz

Alison Metz
Allison Metz (biography)

Interdisciplinarity has the potential to broaden and deepen our understanding and application of methods and tools to address complex challenges. When we embrace interdisciplinarity we broaden what we know about the potential methods for assessing and tackling problems, and we deepen our understanding of specific methods by applying these methods across different contexts. In my pursuit to understand co-creative processes by interconnected stakeholders – i.e., the deep and authentic engagement of stakeholders across governance, science, and community boundaries to identify and optimize the use of evidence for positive outcomes – I have been influenced by methods used outside of my discipline of implementation science and current context of child welfare services. For example, I recently read an article that studied the co-production of knowledge in soils governance (Prager & McKee, 2015) in the United Kingdom and was struck by the usefulness of these ideas for child welfare services in the United States.

The authors use a methodology referred to as “action arenas” to describe and discern the co-production processes that take place between specific stakeholder groups in soils governance.

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Co-creation, co-design, co-production, co-construction: Same or different?

By Allison Metz

Alison Metz
Allison Metz (biography)

A key topic across disciplines is the authentic engagement and participation of key stakeholders in developing and guiding innovations to solve problems.  Complex systems consist of dense webs of relationships where individual stakeholders self-organize through interactions.  Research demonstrates that successful uptake of innovations requires genuine and meaningful interaction among researchers, service providers, policy makers, consumers, and other key stakeholders. Implementation efforts must address the various needs of these stakeholders.  However, these efforts are described differently across disciplines and contexts – co-design, co-production, co-creation, and co-construction.

Developing consensus on terminology and meanings will facilitate future research and application of “co” concepts.  For example, co-design is often used in health to describe processes that put users and communities at the heart of service design. Co-production is often discussed in socio-environmental science to allow users to participate in administration and delivery.  Co-creation is often used in business to describe the involvement of customers in developing products and processes. 

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