American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

From the Director's Desk

Implementation Science: What Does This Mean to Us?

Heidi Nelson, MD, FACS

Heidi Nelson, MD, FACS
Medical Director, ACS Cancer Programs

The implementation of existing best medical evidence and best clinical practices has been fundamental to the Commission on Cancer (CoC) since the framers drafted and published their vision for the future of coordinated, standards-based, multidisciplinary cancer care. Indeed, the CoC has repeatedly demonstrated the power of using standards and quality measures as tools to transform best practices into routine practices, so that best current treatments are incorporated into daily cancer care in a timely fashion. Patient lives have been saved and their cancer care experiences have been measurably improved thanks to the CoC and all of you. So, what is this new field of implementation science, and why should we now turn our attention to it?

Implementation science can be thought of as simply the more rigorous and systematic approach to transforming proven knowledge, therapies, and health care strategies into daily routine care. As an emerging science, it is designed to provide us with methods for overcoming barriers to the dissemination and implementation of new best practices. There are many reasons why implementation science is starting to take hold, but largely it is driven by the recognition that life-altering new discoveries and therapies can take on average 17 years to reach patients. It is also driven by the fact that the doubling rate of new knowledge is now under a year, and the number of new cancer therapies is rapidly accelerating. If the opportunities for developing new standards and quality measures are moving faster, are we prepared to keep pace?

We cannot address all new evidence and best practices, so we might use implementation science to identify areas where we can have the greatest impact. The Cancer Research Program’s Dissemination and Implementation Committee has started us on this journey, and they have already demonstrated how tumor boards can expedite dissemination of new results from important clinical trials. Over the coming months, we will share more about the nuanced differences between education, dissemination, quality improvement, and implementation science and how we can embrace new methods that might help us take a new step toward delivering on the vision of our founders.