Changing practice does not often occur just because evidence becomes available. Translating research evidence into practice requires deliberate and planned effort. Implementation focuses on actively supporting the uptake of evidence-based interventions and practices.
The related but different activity of implementation research (science) is 'the scientific study of methods to promote the systematic uptake of research findings and other evidence-based practices into routine practice'. [1,2]
Implementation aims to increase the use of interventions and practices for which there is evidence of effectiveness. This might be in response to a current lack of programs or to replace programs that are not working or are less efficient. Studies of implementation have evolved from an initial focus on service and client outcomes to recognition of the importance of implementation outcomes (each defined below). [2,4]
In Proctors' model, implementation outcomes are defined as 'the effects of deliberate and purposive actions to implement new treatment, practices, and services.'  Examination of this helps us to understand what facilitates or blocks success of an implementation strategy which in turn affects both service and client outcomes. In clinical terms it tells us what works in practice based on effectiveness of the implemented change and expands on this to capture the contextual factors contributing to a successful outcome.
Understanding how implementation fits in to the process of taking evidence to practice helps. Sometimes it can be difficult to understand what is meant by implementation and implementation science. Curran  has created a teaching slide to help health professionals understand what implementation does. Implementation simply looks at how best to help people and organisations do the thing needing to be implemented.
When defining implementation science,  some very non-scientific language can be helpful....
Used under the Creative Commons Attribution 4.0 International License Copyright, BioMedCentral
The Cochrane Collaboration's Review Group on Effective Practice and Organisation of Care has identified four broad categories of implementation strategy interventions targeted at either: healthcare organisations, healthcare recipients, healthcare workers, or specific types of practice, conditions or settings. Many of these are widely used in practice, and a large number of systematic reviews have examined their effectiveness. The Rx for Change Interventions Database (Canadian Agency for Drugs and Technologies in Health) identifies a staggering body of literature that attempts to identify what interventions work and in what circumstances.
There is no strategy suitable for all circumstances, and what works
best will depend on the intervention, the setting, the people involved
and what resources the project has. Improving the reporting of
implementations tudies wil help us build our understanding of what works
in what contexts.  The Standards for reporting Implementation Studies (StaRI) statement
will lead to comparable studies that will help in this regard.
Nevertheless, Wensing recommends working creatively to plan a
cost-effective mix of approaches tailored to the local setting, relying
where possible on methods that have worked elsewhere in similar
It is worth noting that there have only been a few KT and
Implementation theories, models and frameworks used in end of life
studies.  Palliative care specific models such as the Evidence-based
Model for the Transfer and Exchange of Research Knowledge (EMTReK) are
now emerging. 
Queensland Health has a video on implementing a practice change and the different strategies you might consider depending on local circumstances.
Visit Queensland Health Implementation
Plan the implementation! Possibly the most important element of
implementing change is to actually plan the implementation, rather than
assume it will automatically happen on the strength of the identified
need or the evidence alone.
Wensing  emphasises the importance of planning. First, there
should be a good basis for change. This could be new scientific
knowledge, or perhaps a particular problem or best practice is
identified. Second, the implementation should be planned (when, where,
how, and by whom the implementation will occur). Clearly outlining the
advantages of change, and solutions for any possible disadvantages also
helps.  A diagnostic analysis can reveal the target group and
behaviours, and identify barriers and facilitators to change. In common
with dissemination, program logic models and theories of change are
useful tools in planning implementation programs.
The general principles of planning are similar across different projects and circumstances but include: 
Implementation effectiveness with different KT strategies varies.
How well the barriers to implementation can be overcome has been
identified as a key factor in success. 
Characteristics of successful innovations include: 
Identifying factors or determinants that might facilitate or
block change is important because targeting these can result in a more
effective implementation strategy. 
Tools such as Identifying Barriers to Evidence Uptake (NICS) and How To: Implement Change Successfully (113kb pdf)
(University Hospitals Bristol, UK) may be useful in your clinical
implementation project. Planning for change can benefit from input from
theories on implementation of change. Visit the pages on theories of change for an overview of how these can help facilitate stakeholder involvement and uptake of change.
Knowing whether your organisation is ready to implement change is a key consideration when planning for change. A range of tools are available to help with your assessment of readiness to change. The Canadian Knowledge Translation Program has a useful Decision Support tool to help you choose which one to use.
Visit Knowledge Translation Program's Assessing organizational readiness for change (Ready, Set, Change!)
Assessing organizatinal readiness for change
Last updated 04 May 2022