“There is nothing so practical as a good theory”: a pragmatic guide for selecting theoretical approaches for implementation projects

BMC Health Services Research. 2018;18(1):1-11 DOI 10.1186/s12913-018-3671-z


Journal Homepage

Journal Title: BMC Health Services Research

ISSN: 1472-6963 (Online)

Publisher: BMC

LCC Subject Category: Medicine: Public aspects of medicine

Country of publisher: United Kingdom

Language of fulltext: English

Full-text formats available: PDF, HTML



Elizabeth A. Lynch (Adelaide Nursing School, Faculty of Health and Medical Sciences, The University of Adelaide)

Alison Mudge (Internal Medicine and Aged Care, Royal Brisbane and Women’s Hospital)

Sarah Knowles (Alliance Manchester Business School – People, Management and Organisation Division, The University of Manchester)

Alison L. Kitson (College of Nursing and Health Sciences, Flinders University)

Sarah C. Hunter (College of Nursing and Health Sciences, Flinders University)

Gill Harvey (Adelaide Nursing School, Faculty of Health and Medical Sciences, The University of Adelaide)


Open peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 23 weeks


Abstract | Full Text

Abstract Background A multitude of theories, models and frameworks relating to implementing evidence-based practice in health care exist, which can be overwhelming for clinicians and clinical researchers new to the field of implementation science. Clinicians often bear responsibility for implementation, but may be unfamiliar with theoretical approaches designed to inform or understand implementation. Main text In this article, a multidisciplinary group of clinicians and health service researchers present a pragmatic guide to help clinicians and clinical researchers understand what implementation theories, models and frameworks are; how a theoretical approach to implementation might be used; and some prompts to consider when selecting a theoretical approach for an implementation project. Ten commonly used and highly cited theoretical approaches are presented, none of which have been utilised to their full potential in the literature to date. Specifically, theoretical approaches tend to be applied retrospectively to evaluate or interpret findings from a completed implementation project, rather than being used to plan and design theory-informed implementation strategies which would intuitively have a greater likelihood of success. We emphasise that there is no right or wrong way of selecting a theoretical approach, but encourage clinicians to carefully consider the project’s purpose, scope and available data and resources to allow them to select an approach that is most likely to “value-add” to the implementation project. Conclusion By assisting clinicians and clinical researchers to become confident in selecting and applying theoretical approaches to implementation, we anticipate an increase in theory-informed implementation projects. This then will contribute to more nuanced advice on how to address evidence-practice gaps and ultimately to contribute to better health outcomes.