The Implementation Science Workbook
Get a proven practice adopted, measured and sustained across a system.
The problem it solves
Implementation science has powerful frameworks and a well-documented habit of being misapplied: a framework named but never used, barriers matched to strategies with no stated logic, a study that measures only the clinical outcome and so cannot explain why it failed.
How it works
You do not read about CFIR here, you complete a CFIR assessment; you do not cite ERIC, you match and specify strategies. The step up from a local audit or EBP project to something that holds across a system.
Who it is for
- Clinical leads rolling a proven practice out beyond one ward
- Improvement teams whose pilot worked and then stalled
- Grant applicants who need a defensible implementation section
Who should look elsewhere. If you have not yet demonstrated the practice works locally, start with the audit and QI workbook or the EBP workbook — this one begins from a proven practice that is not being used. If you are testing whether an intervention works at all, that is effectiveness research, not implementation.
What is inside
- Classifying the project and quantifying the know-do gap
- A CFIR determinant assessment, completed rather than cited
- A prioritised barrier and facilitator register
- Matching ERIC strategies to barriers, with the logic written down
- Specifying each strategy so another team could replicate it
- Proctor implementation outcomes, defined and measured alongside the clinical one
- A RE-AIM evaluation plan across all five dimensions
- Choosing a hybrid design, and phasing with EPIS
- Sustainability, and de-implementation of what the change replaces
- A StaRI-structured report, and a fundable implementation section
What you will have finished
- A classified project and a quantified know-do gap
- A completed CFIR determinant assessment and a prioritised barrier register
- ERIC strategies matched to your barriers and specified so others can replicate them
- Proctor implementation outcomes measured alongside the clinical one
- A RE-AIM evaluation across all five dimensions, not effectiveness alone
- A hybrid design, an EPIS phasing plan, and a sustainability and de-implementation plan
- A StaRI-structured report and a fundable implementation section for a grant
What this adds to the free guidance
The CFIR team published a user guide specifically because of the misuse they kept seeing: a framework named in the methods and never used, barriers matched to strategies with no stated reasoning, CFIR and RE-AIM bolted together without distinguishing determinants from outcomes, and evaluations that measure only the clinical result and so cannot explain a failure. The free framework PDFs tell you what the frameworks are. They do not make you complete one. Here you do not read about CFIR, you complete a CFIR assessment.
Built on CFIR, TDF, ERIC, Proctor, RE-AIM, EPIS, StaRI. Original tools that operationalise the published standards and point to the free official sources.
Frequently asked questions
What is the difference between quality improvement and implementation science?
QI asks whether you can improve a local process. Implementation science asks why a practice already known to work is not being used, and what it takes to get it adopted and sustained across a system. Different question, different frameworks, different outcomes measured — and the second usually follows the first.
Do I have to use CFIR and RE-AIM together?
They answer different questions and are commonly conflated. CFIR characterises determinants — what will help or hinder. RE-AIM evaluates outcomes across reach, effectiveness, adoption, implementation and maintenance. Using both is legitimate and common, provided you can say which does what in your study.
What are implementation outcomes, and why measure them separately?
Proctor's set — acceptability, adoption, appropriateness, feasibility, fidelity, cost, penetration, sustainability — describe how well the change was delivered, distinct from whether the clinical outcome moved. Without them a null result is uninterpretable: you cannot tell whether the practice failed or was never really implemented.
Is this useful for a grant application?
That is one of its stated purposes. The final chapter builds a fundable implementation section, and the specification of strategies is exactly the detail reviewers look for and rarely receive.