Balancing fidelity and flexibility: a case study presentation of an augmented dynamic adaptation process for socio-technical innovations in healthcare

Introduction: The key challenge of successful implementation of healthcare innovations is balancing between intervention fidelity and the constantly changing healthcare environment where the implementation occurs. Unexpected changes as well as staff turnover are likely to affect implementation success and sustainability. Ensuring implementation fidelity requires researchers to adhere to the study design and implementation plan. Methods: We augmented the Dynamic Adaptation Process model using strategies from quality improvement, clinical safety, and software development agility to allow for continuous adaptation of the implementation process to changes in community healthcare settings and to reduce the chance of implementation failure when implementing complex socio-technical solutions in fast-paced healthcare environments. Results/discussion: This project illustrates how this augmented model could avert “implementation failure” based on real-life implementation cases of a socio-technical innovation to optimize cross-sector collaborations to support patients with medical, social and behavioral complexities. Key takeaways from the project highlight the importance of understanding baseline organizational readiness, designing for sustainability and spread, prioritizing engagement and communication, and ensuring a holistic design of socio-technical solutions.