Background and purpose: Radiotherapy (RT) is rapidly advancing, yet only 50 % of innovations are implemented promptly. Despite the availability of Implementation Science (ImpSci) theories, models, and frameworks (TMFs), a theory–practice gap persists in effectively applying these insights in RT clinical practice. This study aims to develop a consensus-based implementation protocol for RT innovations using validated ImpSci knowledge. Material and methods: A literature review of TMFs (May–August 2023) and 20 semi-structured interviews with Dutch RT professionals (August–December 2023) identified key RT components for implementation. These insights informed a draft RT implementation protocol, which was refined through a three-round international Delphi study (March–September 2024) involving 11 RT and 5 ImpSci experts. Consensus was determined using a 5-point Likert scale, analysing medians, interquartile ranges (IQRs), and percentage scoring. Results: The Knowledge-to-Action (KTA) Framework and input from expert interviews were used to draft the protocol. Delphi response rates were 100 %, 93.8 %, and 88.9 % across rounds. In round 1, 88.9 % of elements achieved consensus (median = 4.0, IQR = 0.0–1.3); only the application of a prediction model for timely implementation (step 3c) needed revision after rounds 1 and 2. In round 3, also for step 3c consensus was reached (median = 4.0, IQR = 0.3). The protocol includes defining innovation types, stakeholder analysis, tailored implementation strategies, and a phased evaluation plan to ensure sustainability. Conclusion: This is the first consensus-based RT innovation implementation protocol, addressing the theory–practice gap with a structured clinical approach. Future research should validate the protocol and assess the impact of preparation on implementation success.
The road to successful implementation of innovation in radiotherapy: A research-based implementation protocol / Ho F.; Swart R.; Boersma L.; Fijten R.; Cremers P.; van Merode F.; Jacobs M.; Alongi F.; Belderbos J.; Bhattacharya I.S.; Buijsen J.; van Dieren E.; Dirkx M.L.P.; van der Geest A.M.; Grau C.; Guckenberger M.; Houweling A.C.; Jereczek-Fossa B.A.; Jetten L.; Kleijnen J.-P.J.E.; Koetsveld F.; Koppe F.; Krol A.D.G.; de Langen M.; Langendijk J.A.; Lievens Y.; Mast M.E.; Meattini I.; Bas Nijsten S.M.J.J.G.; Peters N.; Poortmans P.; Scorsetti M.; Slotman B.J.; Troost E.; Ulehake M.; Vandemaele M.; Venema-Spoelder J.; Veninga T.; Verheij M.; Walters B.H.; Sandra de Wringer - van Vliet A.S.. - In: RADIOTHERAPY AND ONCOLOGY. - ISSN 0167-8140. - ELETTRONICO. - 207:(2025), pp. 110874.0-110874.0. [10.1016/j.radonc.2025.110874]
The road to successful implementation of innovation in radiotherapy: A research-based implementation protocol
Meattini I.;
2025
Abstract
Background and purpose: Radiotherapy (RT) is rapidly advancing, yet only 50 % of innovations are implemented promptly. Despite the availability of Implementation Science (ImpSci) theories, models, and frameworks (TMFs), a theory–practice gap persists in effectively applying these insights in RT clinical practice. This study aims to develop a consensus-based implementation protocol for RT innovations using validated ImpSci knowledge. Material and methods: A literature review of TMFs (May–August 2023) and 20 semi-structured interviews with Dutch RT professionals (August–December 2023) identified key RT components for implementation. These insights informed a draft RT implementation protocol, which was refined through a three-round international Delphi study (March–September 2024) involving 11 RT and 5 ImpSci experts. Consensus was determined using a 5-point Likert scale, analysing medians, interquartile ranges (IQRs), and percentage scoring. Results: The Knowledge-to-Action (KTA) Framework and input from expert interviews were used to draft the protocol. Delphi response rates were 100 %, 93.8 %, and 88.9 % across rounds. In round 1, 88.9 % of elements achieved consensus (median = 4.0, IQR = 0.0–1.3); only the application of a prediction model for timely implementation (step 3c) needed revision after rounds 1 and 2. In round 3, also for step 3c consensus was reached (median = 4.0, IQR = 0.3). The protocol includes defining innovation types, stakeholder analysis, tailored implementation strategies, and a phased evaluation plan to ensure sustainability. Conclusion: This is the first consensus-based RT innovation implementation protocol, addressing the theory–practice gap with a structured clinical approach. Future research should validate the protocol and assess the impact of preparation on implementation success.
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