I first started thinking about implementation science before I even knew what it was called. I had just finished my post-graduate medical training in the specialty of Infectious Diseases, and I was overseeing an infection prevention program at a large safety net hospital. 

Infection prevention programs are responsible for preventing and controlling the spread of infections; and unfortunately, ours, was not doing a good job at that. Nurses and doctors were not washing their hands; medical devices were frequently getting infected; and there were outbreaks of highly resistant bacteria in our hospital wards. We had implemented countless protocols to improve our prevention processes, but I lacked the language to describe all the barriers I was encountering. I was in over my head.

In 2015, I moved to Iowa City and joined the Division of Infectious Diseases at the Carver College of Medicine. In this new role, I started developing an antibiotic stewardship program at the Iowa City Veterans Affairs hospital. Antibiotic stewardship programs work to improve how antibiotics are prescribed to patients. One of their primary goals of these programs is to reduce the spread of antibiotic-resistant bacteria, a common but undesirable effect of antibiotic exposure. Here, too, I faced the challenge of implementing evidence, specifically evidence on how to prescribe antibiotics in a way that maximizes their benefit and minimizes their harm. 

While at the University of Iowa, I became introduced to the field of implementation science. Implementation science explores how to accelerate the adoption of research findings, and this aligned well with my work in antibiotic stewardship, where I was trying to help healthcare providers adopt medical evidence on how to prescribe antibiotics. In many cases, this involved prescribing antibiotics for shorter courses or not prescribing antibiotics at all. For a provider, changing behavior based on new evidence can be intimidating and unsettling. I know, because I’ve have experienced these same challenges when caring for my own patients.

Over the years, I have worked with multidisciplinary teams to understand barriers to better antibiotic-prescribing and to understand how strategies to improve prescribing can be implemented. I have written papers and given lectures on how the concepts of implementation science can be applied to my field of antibiotic stewardship. And I’ve I have enjoyed sharing what I know about implementation science with colleagues from across the country, who are encountering the same everyday challenges that I do. 

Through my work with the University of Iowa’s Implementation Science Center, I look forward to helping other people learn and apply the tools of implementation science to their own medical discipline. 

Medicine is a constantly changing field with new studies being published every day. Some of these studies reinforce what we already know. Others shift the paradigm on how certain diseases should be diagnosed or treated. Bridging the gap between this new evidence and everyday practice takes deliberate effort and addressing barriers to change. And, in most cases, addressing barriers to change. Implementation science provides the tools we need to describe–and ultimately overcome– these barriers. It also helps develop strategies to overcome them.