Operational research joins implementation science
Thomas Monk (2016) describes how operational research (OR) and implementation science can be woven together to achieve a common goal-to solve problems. In healthcare, we utilize both methods to find solutions, such as how to reduce hospital readmissions or how to decrease patient wait times. Although operations and implementation work toward a common goal, they each take a unique approach. OR professionals create models that forecast relationships, use statistical analysis, and implement various allocation strategies. This research focuses heavily on advanced analytical methods, and is a necessary step to encourage the decision making process in implementation strategies. Implementation science uses various methods to integrate research findings into healthcare and focuses on testing new approaches to improve healthcare delivery. Implementation science also examines the relationship between the intervention and the results. The role of OR in implementation science has been up for debate, but if fused together, researchers would use both mathematical and social strategies to create an effective solution to a complex healthcare problem.
Below is an abstract from Thomas Monk’s article Operational Research as implementation science: definitions, challenges and research priorities
Abstract
Background
Operational research (OR) is the discipline of using models, either quantitative or qualitative, to aid decision-making in complex implementation problems. The methods of OR have been used in healthcare since the 1950s in diverse areas such as emergency medicine and the interface between acute and community care; hospital performance; scheduling and management of patient home visits; scheduling of patient appointments; and many other complex implementation problems of an operational or logistical nature.
Discussion
To date, there has been limited debate about the role that operational research should take within implementation science. I detail three such roles for OR all grounded in upfront system thinking: structuring implementation problems, prospective evaluation of improvement interventions, and strategic reconfiguration. Case studies from mental health, emergency medicine, and stroke care are used to illustrate each role. I then describe the challenges for applied OR within implementation science at the organisational, interventional, and disciplinary levels. Two key challenges include the difficulty faced in achieving a position of mutual understanding between implementation scientists and research users and a stark lack of evaluation of OR interventions. To address these challenges, I propose a research agenda to evaluate applied OR through the lens of implementation science, the liberation of OR from the specialist research and consultancy environment, and co-design of models with service users.
Summary
Operational research is a mature discipline that has developed a significant volume of methodology to improve health services. OR offers implementation scientists the opportunity to do more upfront system thinking before committing resources or taking risks. OR has three roles within implementation science: structuring an implementation problem, prospective evaluation of implementation problems, and a tool for strategic reconfiguration of health services. Challenges facing OR as implementation science include limited evidence and evaluation of impact, limited service user involvement, a lack of managerial awareness, effective communication between research users and OR modellers, and availability of healthcare data. To progress the science, a focus is needed in three key areas: evaluation of OR interventions, embedding the knowledge of OR in health services, and educating OR modellers about the aims and benefits of service user involvement.
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