April Journal Club Feedback

The latest meeting of the UK-IS Journal Club took place on 26th April 2022. Hosted by UK-IS Trustee and Interim Chair Dr Tom Jefford, the group reviewed Spreading and scaling up innovation and improvement Trish Greenhalgh and Chrysanthi Papoutsi BMJ 2019;365:l2068


Key Messages

  • Spread (replicating an intervention) and scale-up (building infrastructure to support full scale implementation) are difficult

  • Implementation science takes a structured and phased approach to developing, replicating, and evaluating an intervention in multiple sites

  • Complexity science encourages a flexible and adaptive approach to change in a dynamic, self organising system

  • Social science approaches consider why people act in the way they do, especially the organisational and wider social forces that shape and constrain people’s actions

  • These approaches may be used in combination to tackle the challenges of spread and scale-up



The paper is seen as a helpful and jargon free article which distils out three differing perspectives; implementation science, complexity science and social science when thinking about the spread and scale up of innovations.

The paper has relevance for the early stage entrant to implementation science as well as for those with more familiarity with it and can be used as an introductory paper for those who are seeking a way into understanding of key concepts and debates.

The participants discussed how adaptation can be seen as both necessary and potentially corrupting as organisations shape around the innovation being scaled.

Differences between professional disciplines were explored and how values can play a part in gaining traction for change. The challenges of end user and patient involvement in collaboration and in research of implementation was also discussed as an area for further exploration.

Hosted/summarised by Tom Jefford

© UK Implementation Society, 2022

All views expressed are the author's own and not those of the UK Implementation Society.

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