Choices are a good thing, right? But what happens when we apply choice to the Cost-Quality-Time Triangle for implementation of a new program or practice?
If we can only choose 2, say we choose, “time” and “cost”, we can implement a program or practice quickly and relatively cheaply, but the quality of service delivery (or fidelity) may suffer. If we choose “cost” and “quality”, we can expect reasonable costs and high quality work but that would take time. In most organizations, time and cost are the biggest constraints/barriers. Yet the expectation (and frankly lives of consumers may be dependent on it) is for high quality services. The quality or in this example the quality of program delivery as intended tends to suffer.
Implementation of an Evidence-Based Program (EBP), or Evidence-Informed Innovation (EII) with quality takes time and will introduce high costs (fiscal and personnel).
So how do leaders and stakeholders balance this “Triangle” to ensure that EBPs/EIIs are actually yielding the results they are purported to deliver? How do we shift the focus to quality of service delivery and manage the costs and time it takes for all consumers to experience the benefits?
The answer may lie in looking further into another “triangle” that describes the implementation infrastructure; the Implementation Drivers.
Implementation Drivers are divided into three categories: 1) Staff Competency Drivers (how do you support staff delivering programs as intended), 2) Organization Drivers (how do you recreate the system to ensure that staff have the time and opportunity to learn how to deliver the program with quality) and 3) Leadership Drivers (how do you empower leaders to support and build a new culture).
The great thing about the Implementation Drivers infrastructure is that together, they form the platform to build off current systems within an organization so that the organization does not have to start from scratch (saving time and cost). In addition, when a system such as this is created to align with implementation of the program or practice as intended, we can ensure high quality and sustainable program delivery (quality).
Conclusion: Maybe we don’t have to choose 2. With the help of Implementation Science, it is possible to create reliable high quality services that benefit consumers for generations to come. Investing in Implementation practices today, will yield a return on investment tomorrow.
We asked a leader in the education field to share his thoughts on the cost of implementation. Please click here to read the Invited Commentary.
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Implementation Scientists, LLC website content by Dr. Michelle A Duda is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Based on a work at Implementation Scientists, LLC.