Local Adaptation Needed for New Interventions

Dr David Chambers from the National Cancer Institute (NCI) in the United States has told a Sydney Health Partners’ conference that “some of our interventions are designed so that they are about as useful as a bicycle is to a fish.”

“We assume that health systems are static, and consumers are homogenous, and that implementation proceeds just one practice or test at time,” he said. “We don’t think enough about adaption and fidelity.”

Dr Chambers, who is the Deputy Director of Implementation Science at NCI, gave the keynote address to Sydney Health Partners’ 2020 Implementation Science Symposium Under pressure: implementing change to transform healthcare, watched by online audience of more than 400 people over three days (November 17-19).

The Symposium also featured a keynote address by Oxford University Professor Trish Greenhalgh, who is an internationally recognised expert in primary health care and the organisation and delivery of health services.

Speaking about the politics of COVID-19, Professor Greenhalgh observed that in response the pandemic research commenced at an unprecedented scale and “too little knowledge quickly became too much.”

“As a result, facts became contested and saturated with ideology … and there is a need to deconstruct what is actually science here and what is not science,” she said.

The Chief Executive of the NSW Agency for Clinical Innovation Professor Jean-Frederic Levesque told the Symposium that in the face of the COVID-19 crisis, the creation of a NSW Health Critical Intelligence Unit to synthesize evidence and advise decision-makers has been a great success.

“Health and medical researchers needed a safe space to debate the emerging evidence,” he said. “There couldn’t be a randomised controlled trial for most decisions, so the evidence presented needed to be brief, timely and good enough.”

Professor Julie Leask from the University of Sydney told the Symposium that the attention of implementation scientists was now tuning to how ensure high vaccination rates once COVID-19 vaccines become available.

“Implementation Science has within it behaviour change frameworks which have been used successfully by the World Health Organisation to increase vaccination rates in some European countries,” she said.

The Symposium also featured the launch of the Sydney Health Partners Implementation Science Community of Practice – a new website, which facilitates connection, collaboration and the sharing of resources.

To join the community - and watch Symposium presentations by Dr Chambers and Professor Greenhalgh - go to implementationscience.com.au