Advancing research on teams and team effectiveness in implementation science: An application of the Exploration, Preparation, Implementation, Sustainment (EPIS) framework

Elizabeth A McGuier; David J Kolko; Nicole A Stadnick; Lauren Brookman-Frazee; Courtney Benjamin Wolk; Christina T Yuan; C Shawn Burke; Gregory A Aarons

doi:10.1177/26334895231190855

Advancing research on teams and team effectiveness in implementation science: An application of the Exploration, Preparation, Implementation, Sustainment (EPIS) framework

Implement Res Pract. 2023 Jul 27:4:26334895231190855. doi: 10.1177/26334895231190855. eCollection 2023 Jan-Dec.

Authors

Elizabeth A McGuier¹, David J Kolko¹, Nicole A Stadnick^{2

3

4}, Lauren Brookman-Frazee^{2

3

4}, Courtney Benjamin Wolk^{5

6}, Christina T Yuan⁷, C Shawn Burke⁸, Gregory A Aarons^{2

3

4}

Affiliations

¹ Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
² Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
³ UC San Diego ACTRI Dissemination and Implementation Science Center, La Jolla, CA, USA.
⁴ Child and Adolescent Services Research Center, San Diego, CA, USA.
⁵ Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
⁶ Penn Implementation Science Center at the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
⁷ Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁸ Institute for Simulation and Training, School of Modeling, Simulation, and Training, University of Central Florida, Orlando, FL, USA.

Abstract

Background: Effective teams are essential to high-quality healthcare. However, teams, team-level constructs, and team effectiveness strategies are poorly delineated in implementation science theories, models, and frameworks (TMFs), hindering our understanding of how teams may influence implementation. The Exploration, Preparation, Implementation, Sustainment (EPIS) framework is a flexible and accommodating framework that can facilitate the application of team effectiveness approaches in implementation science.

Main text: We define teams and provide an overview of key constructs in team effectiveness research. We describe ways to conceptualize different types of teams and team constructs relevant to implementation within the EPIS framework. Three case examples illustrate the application of EPIS to implementation studies involving teams. Within each study, we describe the structure of the team and how team constructs influenced implementation processes and outcomes.

Conclusions: Integrating teams and team constructs into the EPIS framework demonstrates how TMFs can be applied to advance our understanding of teams and implementation. Implementation strategies that target team effectiveness may improve implementation outcomes in team-based settings. Incorporation of teams into implementation TMFs is necessary to facilitate application of team effectiveness research in implementation science.

Keywords: EPIS; implementation outcomes; team; teamwork.

Plain language summary

Teams and team-level constructs are neglected in implementation theories, models, and frameworks (TMFs). This paper calls attention to the importance of teams in implementation research and practice and provides an overview of team effectiveness research for implementation science. We illustrate how the EPIS framework can be applied to advance our understanding of how teams influence implementation processes and outcomes. We identify future directions for research on teams and implementation, including developing and testing implementation strategies that focus on team effectiveness.

Abstract

Plain language summary

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