Implementation as transfer between policy, research and practice in care.

Background: Health Services Research is policy related and results have an impact on practices. Implementation of research output into practices is performed with a variety of strategies. Type of policy intentions and research output create a specific context for implementation. The main question here is: what combinations of background factors and implementation strategies lead to successful implementations in health care? Methods: Sources for this study are evaluations of 72 completed implementation projects in health care settings (60% of all projects were evaluated as successful). Qualitative analyses focused on clustering background factors: social environment of professionals and users, types of interventions, organizational structure and culture. Quantitative analyses were based on systematic gathered information with registration formula. First, characteristics are registered, like goals, strategy choice, organizational change, perception of change, support of management. Second, successful implementation as independent variable was included. For each implementation goal success was measured (1 = goal is not reached; 5 = goal is fully reached). A second measure of success was: integration of implemented products in organization or procedures (1 = no/ low integration; 5 = highly integrated). Results: Qualitative analyses resulted in clustering five types of implementation. Nationwide organization oriented change (e.g. implementing quality systems), nationwide user oriented prevention and care, (e.g. web-based prevention of alcohol abuse), implementation of profession oriented guidelines, effect- and validation studies (testing instruments), information and education for care users (e.g. support for parent– child relations). Preliminary results from quantitative analysis show that 80% of pre-set goals are achieved. But the success factor of integration is for only 20% of all projects mentioned. Conclusions: Success in implementation projects is reached highly if we define success as reaching pre-set goals, but implementation is not very successful if success is defined as integration. The question is: when is implementation completed and are all projects we define as implementation really implementing products