Agile Implementation: Reengineering dissemination of healthcare in the US

May 8, 2018, Regenstrief Institute
Agile Implementation is a modern-day formula for quality improvement. Efficient, sustainable, scalable, and human-centric, Agile Implementation methodology could be used in a variety of fields beyond healthcare. Credit: Indiana University Center for Health Innovation and Implementation Science

In a study published in the Journal of the American Geriatrics Society, clinician-researchers and implementation scientists from the Regenstrief Institute, Eskenazi Health, and Indiana University address the escalating need for faster implementation of healthcare innovation. The authors present Agile Implementation, a simple new methodology which they designed, developed, embedded and tested. Agile Implementation enables fast, efficient, scalable, sustainable and effective dissemination of evidence-based healthcare solutions.

The need is great. For example, as the ratio of older to younger Americans increases, will struggle to find family and professional providers to support their care, especially the care of the approximately one in five older adults with a mental health or substance abuse problems—including lifelong conditions and late life onset illnesses such as Alzheimer's disease. But evidence-based models of care developed to serve these older adults have inadequately spread to caregivers, healthcare systems and the older adults themselves according to the study authors.

To support the spread of innovation, Agile Implementation reorders and reprioritizes the implementation steps so that the families of older adults, their caregivers, primary care physician, healthcare system or other large or small organization pulls the solution rather than the innovator pushing it forward. End-users—in this case those providing various aspects of care to older adults—apply their own criteria to determine an innovation's value and thus Agile Implementation recognizes end-users as the informed customer.

"We created Agile Implementation because we saw a huge need for rapid diffusion of evidence-based solutions to pressing problems in the healthcare delivery system," said Regenstrief Institute and IU Center for Aging Research scientist Malaz Boustani, MD, MPH, senior author of the new study and the founding director of the IU Center for Health Innovation and Implementation Science. "While our initial focus has been on older adults, a vulnerable population, Agile Implementation methodology provides a universal platform to implement any evidence-based innovation in any environment in which humans are the major players from all aspects of healthcare to such areas as finance or technology."

The eight steps of the Agile Implementation methodology are: 1) identify opportunities; 2) identify evidence-based healthcare services; 3) develop evaluation and termination plans; 4) assemble a team to develop a minimally viable service; 5) perform implementation sprints; 6) monitor implementation performance; 7) monitor whole system performance; and 8) develop a minimally standardized operating procedure.

"Demonstrating effective model of care through rigorous research is important," said study corresponding author Christopher M. Callahan, MD, founding director of the IU Center for Aging Research and a Regenstrief Institute investigator. "But data alone will not lead to rapid diffusion of innovation. We need to recognize the importance of social networking, the barriers of competing priorities, and the opportunities within complex systems to facilitate implementation."

Authors of "A State of Science: Bridging the Science-Practice Gap in Aging, Dementia and Mental Health" in addition to Dr. Boustani, who is the Richard M. Fairbanks Professor of Aging Research at IU School of Medicine and founding director and chief innovation and implementation officer of the Sandra Eskenazi Center for Brain Care Innovation at Eskenazi Health, and Dr. Callahan, who is the chief research and development officer with Eskenazi Health and Cornelius and Yvonne Pettinga Professor of Medicine at IU School of Medicine, are Daniel R. Bateman, MD of the Regenstrief Institute and IU Center for Aging Research and Sophia Wang, MD of the IU Center for Health Innovation and Implementation Science.

In the paper, they identify a number of compelling evidence-based solutions to problems faced by older adults and analyzed their failure to be disseminated. They found that these solutions typically fail to incorporate three important factors in their design—the complexities of health systems, the barriers to diffusion, and the role of human emotion, all of which are taken into account by Agile Implementation.

This work was supported by the Agency for Healthcare Research and Quality Patient Safety Learning Laboratories Program (P30HS024384).

Earlier this year, Dr. Boustani and colleagues published "Agile Implementation: A Blueprint for Implementing Evidence-Based Healthcare Solutions" in the Journal of the American Geriatrics Society.

Agile Implementation is based on the complex adaptive system and social cognitive theories. Those interested in applying Agile Implementation methodology to their system or medical practice can participate in the IU Center for Health Innovation and Implementation Science's unique training opportunities through workshops, short courses, boot camps or graduate certificate programs. Information is available on the center's website.

Explore further: Novel blueprint for faster implementation of more evidence-based healthcare solutions

Related Stories

Novel blueprint for faster implementation of more evidence-based healthcare solutions

March 26, 2018
Scientist-clinicians from the Indiana University Center for Health Innovation and Implementation Science, Regenstrief Institute and IU Center for Aging Research have designed, developed and implemented an effective, simple ...

Impact of Medicare annual wellness visit on detection of cognitive impairment is minimal

April 10, 2018
In the first nationwide study to measure the effect of the Medicare Annual Wellness Visit on early identification of cognitive impairment such as Alzheimer's disease, researchers from the Indiana University Center for Aging ...

Implementation science can create a workforce equipped for new health care environment

May 1, 2014
The new Center for Health Innovation & Implementation Science at the Indiana University School of Medicine and Indiana Clinical and Translational Sciences Institute is studying how best to prepare the future health care workforce ...

Cost-saving, coordinated brain care model for older adults attracting nationwide interest

May 20, 2014
The patient and caregiver-centered Aging Brain Care program, developed by researchers at the Regenstrief Institute and the Indiana University Center for Aging Research, is attracting nationwide interest for its ability to ...

New low cost workforce is effective in decreasing depression burden in primary care

November 3, 2016
The Aging Brain Care Medical Home, a novel brain-focused population health management program implemented in the homes of older adults, lowered depression severity by more than 50 percent over six months according to a new ...

Critical Care Recovery Center concept could benefit adult ICU survivors of all ages

November 14, 2017
A growing number of individuals of all ages are surviving intensive care unit hospitalization, however their mental and physical health problems persist. A new study from Regenstrief Institute and Indiana University researchers ...

Recommended for you

New study finds concurrent use of prescription drugs and dietary supplements could pose health risks

September 25, 2018
A new University of Hertfordshire study found that using certain over-the-counter herbal medicines and dietary supplements alongside prescription drugs could pose serious health risks, especially amongst older adults.

India launches 'Modicare', world's biggest health scheme

September 23, 2018
Prime Minister Narendra Modi on Sunday launched the world's biggest health insurance scheme, promising free coverage for half a billion of India's poorest citizens ahead of national elections next year.

It's not just for kids—even adults appear to benefit from a regular bedtime

September 21, 2018
Sufficient sleep has been proven to help keep the body healthy and the mind sharp. But it's not just an issue of logging at least seven hours of Z's.

Most nations falling short of UN targets to cut premature deaths from chronic diseases

September 21, 2018
People in the UK, US and China have a higher risk of dying early from conditions like cancer, heart disease and stroke than people in Italy, France, South Korea and Australia.

Alcohol responsible for one in 20 deaths worldwide: WHO

September 21, 2018
Alcohol kills three million people worldwide each year—more than AIDS, violence and road accidents combined, the World Health Organization said Friday, adding that men are particularly at risk.

Patient-centered visual aid helps physicians discuss risks, treatments with parents

September 21, 2018
A series of illustrations and charts designed as decision aids for parents of children with minor head injuries helped them communicate with emergency medicine physicians and make informed decisions about their child's care, ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.