Accelerating Implementation of Transportation Research Results (2014)

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10 CHAPTER TWO FACTORS AFFECTING THE USE, TIMING, AND EASE OF IMPLEMENTATION INTRODUCTION This chapter provides a discussion on the factors that affect the timing and ease of implementation of research results. Some factors exist independently, but many are dependent on a variety of other factors in the implementation process and in the deployment environment. There is little informa- tion that links factors to promote success, but by observation a number of factors are present in any one implementation activity. Factors are identified and their contribution to the timing and ease of implementation are provided. Some of the factors are more comprehensive than others and will, therefore, have the potential to make a greater con- tribution to improvements in implementation efforts. Some key factors affecting the use, timing, and ease of implemen- tation will be familiar to the highway community. These fac- tors have established a foothold in highway transportation practice but may not have been significantly exploited or supported. Thus, some organizations have implementation activities that are being done at some level or by pockets of research managers in the highway arena, but are not com- mon practice, or are not routinely applied. The following discussion gives a synthesis of factors used by government, the private sector, academia, and nonprofit user associations. Interestingly, factors apply across the broad perspective of technology implementation work and usually regardless of the context in which it occurred. The factors are not listed in priority order. KEY FACTORS No one activity in the examined broad array of implemen- tation processes stands out as being the ultimate solu- tion—the must-do action—to accelerate use of research results or innovations. Little definitive work has been done to determine a set of reliably successful activities across contexts or domains that uniquely accelerates implementa- tion. The literature and interviews identified a variety of strategies for implementation of research results, technolo- gies, or innovations, but there was no consensus about a set of best actions for accelerating results use, even within programs or agencies that have a focus on implementation or technology transfer. Whether at the institutional or programmatic level, whether stated or implied, and regardless of the degree of experience, typically the implementation goals are to foster and speed the practical application of research results or innovations to practice. Nevertheless, the need to accelerate implementation of research results is recognized or at least strongly implied in all domains examined. The Joint Fire Science Program, a federal multiagency partnership [Departments of Agricul- ture (Forest Service) and Interior, and the U.S. Geological Survey] clearly expresses the concept: “getting new science and technology into use quickly is the key to the success of an applied science program” (Barbour 2007, p. 5). The Agency for Healthcare Research Quality (AHRQ) initiative, Translating Research into Practice, “seeks to accelerate the impact of research on patient care to improve clinical out- comes and enhance cost effectiveness and efficiency” (Car- penter et al. 2015, p. 83). The goal of accelerating implementation of research results is generally intended, but measurement of whether the strategies have had an effect on the speed of implemen- tation or what is a best practice for increasing speed across industries and agencies is still a work in progress. For some organizations, a focus on accelerating implementation of research results is relatively new, happening over approxi- mately the past decade. While still making progress, organi- zations are at different stages in the process of accelerating the use of research results. Some organizations articulate goals and the need for activities promoting adoption and implementation of research results, with the unstated goal of accelerating the use of research results. Many organiza- tions are at the stage that if they are promoting implementa- tion activities, they are therefore, by definition, accelerating implementation. Even if these organizations are not directly stating the need for more rapid use of research results, they are applying a variety of endorsed strategies, and accelera- tion occurs, and occurs more often and more rapidly, than if the strategies were not applied. As mentioned in the above paragraph, other organizations are further along and are vigorously pursuing speeding up the use of research results and other innovations. They have created programs or infra- structures to foster accelerating the use of research results.

11 However, for both these situations, at the earlier stages of activity or having identified a systematic approach, there is little consensus about which processes are most successful. Contexts vary: The concept of accelerating research results to practice is relative depending on the context in which the implementation takes place. Yet regardless of the context, even for vastly different applications, the mis- sion of “faster,” that is, reducing the time it takes to get a product into use, is critical. For the military, a 20-year project that employs implementation strategies that allow technology transition to occur in 10 years is considered as achieving remarkable productivity. For the private sector, Hewlett-Packard’s ability to introduce a new printer, having progressed from design to market in 4 months rather than 9 months, is considered essential for product leadership and competitive advantage. With such differing contexts, the job of determining what general strategy or practice was key to accelerating the pace of the implementation process is very difficult to isolate. Also, depending on the implementation context, strategies that are key elements of the implementa- tion process in one assignment may be of significantly lesser importance in another. There are a variety of contexts that promote implementation success. In the course of this effort, the most frequent implementa- tion interactions generally occurred within three contexts. Figure 1 shows implementation of research results from one government organization to another. The implemen- tation occurs between various levels of government agen- cies—most often federal to federal and federal to state and local, rather than from state to federal, for example. There are some variations, such as implementation of U.S. Depart- ment of Defense (DoD) technologies, flowing from a gov- ernment laboratory to a private-sector contractor to a branch of the military, yet the integration of contractor and military branch is for the most part constructed to be seamless and the process is essentially government to government. FIGURE 1 Implementation activities: one government organization to another. Figure 2 describes the any two-party or often three-party implementation context: government to private sector, gov- ernment to academia, academia to private sector, and other variations such as government and academia partnering to accomplish implementation of research results in the private sector. Because of the research-oriented nature of the aca- demic setting, activity generally flows out of the research university to affect implementation by government or the private sector. FIGURE 2 Implementation activities between and among government, academia, and the private sector. Figure 3 shows the context wherein government, aca- demia, and the private sector work together to accomplish implementation of research results into a specific user com- munity—such as the public or a professional community serving a specific segment of the public. Often an example of this context is found in efforts for implementation of research results into communities dealing with medical clinical prac- tices and behavioral health. FIGURE 3 Implementation activities from government, academia, and the private sector are often in partnership with the public sector. More is often better: The literature and descriptions of implementation practice always discuss multiple techniques, strategies, or actions, coupled together or performed in con- cert. One of the factors that affect implementation and its timing is the use of a variety of options deemed appropri- ate for the specific task at hand. In a discussion of military processes, in Accelerating Technology Transition: Bridging

12 the Valley of Death for Materials and Processes in Defense Systems, the National Academies panels concluded, “there is no single strategy that, if implemented, will accelerate the insertion of new technologies into either commercial or military systems. Instead, it is more likely that the omission of a key element of the many needed will guarantee failure” (National Materials Advisory Board and Board on Manu- facturing and Engineering Design 2004, p. 3). While this quote refers to the whole product cycle, the same is true for a subset of the process. Because each context varies, there was no overarching guidance regarding which items were con- sidered fatal if omitted. In general, the more attention and strategies that are used to foster implementation of research results, the more potential there is for success. Infrastructure maturity: Maturity of the implementation practice in a context is a significant factor that affects timing and ease of the processes to produce results. Medical research has been looking at implementation research for more than 20 years, making an effort to get evidence-based results into patient care practices (Grol and Jones 2000). DoD has devel- oped a highly structured process for technology transition that includes detailed instructions and considerations to enable DoD research products and technology to be used by its part- ners and customers (U.S. Department of Defense 2005). In both of these cases and others such as the USDA and the Fed- eral Laboratory Consortium for Technology Transfer, there are well-developed infrastructures supporting implementa- tion activities. Because these industries or domains have been studying the use and results of implementation efforts, they are further advanced in providing systematic approaches to the business of implementation. They have published docu- mentation, references, and guidance for those who partici- pate; they more clearly recognize the value and importance of implementation activities; and they are more experienced at performing the implementation tasks. Implementation resources: Without exception, in all contexts, if implementation of research results was to be done, there were resources committed to its achieve- ment. Resources are categorized into three primary areas: funding, expertise, and the time to accomplish the stated responsibilities. Implementation is time consuming, expensive, and, at least initially, a drag on performance. Effective innovation implementation often requires hefty investments of time and money in technology start-up, training, user support, monitoring, meetings, and evaluation. (Klein and Knight 2005) Funding is essential, and in many of the discussions on implementation it was a foundational concept—that if the implementation was to occur, it would require financial sup- port. Rogers, in his discussion on the nature of technology transfer—defined as the application of information to use, encompassing implementation—points out that the success of the USDA agricultural extension work was based on ade- quate funding. The efforts to get research results into use were roughly equal to that of the investment in the research (author’s emphasis) (Rogers 2002). Every implementation activity requires some degree of funding, whether the strategy used is a demonstration proj- ect, development of marketing and communications materi- als or planning tools, education and training opportunities, incentives that fostered performance, or other types of meth- ods. In fact, Klein and Knight state that “[i]mplementation is, of course, not cheap. It takes money to offer extensive training, to provide ongoing user support, to launch a com- munications campaign explaining the merits of the innova- tion, and to relax performance standards while employees learn to use the innovation.” (Klein and Knight 2005, p. 245) Additionally, Klein et al. (2001) found that financial resource availability was a significant predictor of the overall qual- ity of an organization’s implementation policies and prac- tices and thus, indirectly, a predictor of the organization’s implementation effectiveness. Certainly there is thinking that funding can address barriers that slow implementation progress. Recently, the National Science Foundation (NSF) initiated a program of investment to accelerate innovation research (AIR 2011), which includes specific support toward developing proofs of concept and technology translation plans and for getting the academic work into the market- place. More than $9 million was awarded to 22 academic research institutions. Resources, whether in the form of time, money, equipment, or materials must be available for the new process, product, service, or strategy to be implemented. (Desouza et al. 2009) Organizations that have more experience in the process of implementation also are more aware of the funding required for implementation efforts. These organizations are better prepared to commit funding to getting the research results into practice, or into the marketplace to be available for use. The financial support of university technology commercial- ization offices is an example of the acknowledgement of nec- essary funding to foster the ultimate use of research results. The advantage for these academic settings is the potential to recoup expenses through licensing and other fees associated with use and commercialization. Conscious of the necessary financial commitments to implementing innovations, government and private-sector organizations alike often have rigorous processes to win- now out potential failures and push forward promising prod- ucts or processes from research efforts. This is particularly important in the new development process within private-

13 sector research and development efforts (Canez et al. 2007). NSF and the U.S. Department of Health and Human Ser- vices, AHRQ both have provided substantial project fund- ing that incorporates the costs of research results to practice efforts. As a note, programs and organizations, for example, FLC, that have reliable implementation funding resources tended to spend some of that money on telling potential users of their success: this acknowledges the excellent work done as well as serves as a marketing tool for research products. FLC annually publishes Technology for Today, highlighting the successes of federal laboratories. The 2011 California DOT Peer Exchange team members determined the following traits are characteristic of people who motivate others to accelerate the adoption of innovations: • Have strong marketing and communication skills. • Are able to plan and run effective, efficient meetings. • Are good brokers of information and resources. • Are strong negotiators. • Have persistence, passion, and drive. • Have people skills. • Understand the technical aspects of a project, but can also create and implement a success- ful marketing plan. • Serve as a conduit between technology experts and all others—including stakeholders within the organization, potential adopters of innovation, and the public. • Are able to recognize gatekeepers and what drives them to accept or reject change. • Are trustworthy and credible; have strong per- sonal working relationships. • Are empowered to work across organizational lines and are in a position that offers access to many different levels of the organization. • Are comfortable working within chaos—have public relations skills. • Are able to think outside the box (understand there is more than one way to get from A to B). (California DOT) Knowledgeable and experienced people are a high- impact factor affecting the time and ease of implementation activities. Expertise for accomplishing the tasks associated with implementation is particularly valuable, whether the expertise lies in the organization pushing the technology out to users or in the organization pulling the technology in to effect change. Additionally, such expertise may reside in the organization, or participate from outside but be associated with the organization in some role such as through participa- tion by nonprofit industry or user associations, consultants, or via various private-sector business incubator organiza- tions. Importantly, this expertise must be talent that is tar- geted to support implementation efforts. The kinds of individuals regarded as successful in the work of implementation activities bring to the job highly developed interpersonal skills for relationship building; they are consummate users and builders of networks and make links and connections within their domains; and they are experts at forming partnerships and collaborations, at marketing, and with other tasks that include getting people involved in the implementation. Kanter states, “[I]nno- vations need connectors—people who know how to find partners in the mainstream business or the outside world” (Kanter 2006, executive summary). One individual inter- viewed gave the sage reminder that implementation is essen- tially a “people business”; that is, skillful people do the work of implementation. It is necessary to emphasize that carving out implementation duties from the responsibilities of scien- tists at the laboratory or research facility, or relying on the project administrators or even business process people on the commercial side of an organization was not seen as suf- ficiently effective in making a positive impact on time and ease of implementation. In a synopsis of a study of more than 30 U.S. and European companies discussing five stages of successful innovation (including commercialization, diffu- sion, and implementation), one chief executive officer stated, “We learned a simple thing: researchers and idea creators do not appreciate the nuances of marketing and commercializa- tion. … In the past we tried to get the researchers involved in the commercialization aspects of the business. … The end result was pain and more pain” (Mariello 2007, p. 9). This observation does not mean that researchers’ expertise is not important in the implementation of research results, but it points to efficiencies gained (including speed of the pro- cess) through placing the necessary talent for research and, similarly, the necessary talent for implementation. Technical expertise of the researcher can convey the technical content of the research, yet this technical knowledge is not the sole basis on which an organization makes the decision to adopt and implement an innovation. Both types of talent are essen- tial; positive impact comes from having the right expertise or combination of expertise to do the job. Expertise to accomplish implementation of innovations also includes a specific role, that of the champion. Champi- ons are an essential element of implementation, and Everett Rogers describes a champion as “a charismatic individual who throws his or her support behind an innovation, thus overcoming the indifference or resistance that the new idea may provoke.” (Rogers 2003, p. 414) Rogers goes on to dis- cuss other research that has shown innovation champions may be powerful individuals in an organization, or they may be lower-level individuals who possess the ability to coordinate the actions of others. [See Chapter 10 of his clas-

14 sic work, Diffusion of Innovations, for a discussion of the importance of champions and a description of their roles in health care, student activism, city government, and a variety of other contexts (Rogers 2003, p. 414–417)]. Allowing time for implementation is fundamental. On the surface this factor may appear counterproductive to the goal of accelerating the pace of implementation results. Yet, in conjunction with the provision of expertise, individuals performing implementation responsibilities must have the time to do the job. This means that implementation experts, whether in-house or hired, require a formal, recognized responsibility for implementation that gives the authority to work on implementation as a primary task. Often in the transportation arena, implementation tasks are assigned as “collateral” duties, only to be accomplished after the main responsibilities are accomplished. In understaffed organiza- tions, the implementation tasks may not be done because of the heavy primary responsibility workloads. The business literature emphasizes the important contri- bution of new product development expertise, the partner- ship with the marketing arm of the organization, or other areas that work together in the various roles to speed a prod- uct to market. Each has specific responsibilities to contribute to the job, and each has committed time to do it. Additionally, time to do the job also implies the necessity for implementation expertise to be committed to the longer- term nature of implementation. Implementation experts in the medical field acknowledge, “RintoP [research into prac- tice] processes should be conceptualized as being a long- term effort. One isolated workshop or training course is not expected to have much impact” (Aagaard-Hansen and Olsen 2009, p. 381). Rosabeth Moss Kanter, a noted business author, writes, “MIT researchers have found that for R&D team members to be truly productive, they have to have been on board for at least two years. At one point Pillsbury real- ized that the average length of time the company took to go from new product development to successful commer- cialization was 24 to 26 months, but the average length of time people spent on the product teams was 18 months. No wonder the company was falling behind on innovation. … Product teams also include those performing implementa- tion responsibilities” (Kanter 2006, p. 8). Culture or climate that fosters innovation: Business, government, and academia discuss the need for an autho- rizing environment in which to promote and apply results of research. A senior product development professional describes the elements of an innovative culture as being: “CREATIVE: Customer-focused, Risk-tolerant, Entrepre- neurial, Aligned with strategy, Technology and scientific excellence, Innovative, Virtual organizations (or creative collaboration), Execution (or) Excellence in project man- agement” (Newman 2009). Additionally, using the term “climate,” Klein and Sorra define the environment that can facilitate or impede implementation, as one where there is “a shared perception among intended users of an innovation, of the extent to which an organization’s implementation poli- cies and practices encourage, cultivate, and reward innova- tion use.” An empowered staff, a supportive management, a fail-fast/win-strong environment, and the host of other cultural elements that foster motivation to pursue change and benefit from it, continue to be an elusive but important aspect of whether research results languish or are expedi- tiously implemented. State departments of transportation (DOTs) are becom- ing more aware of the value of creating a culture that fosters innovation and in turn is more risk tolerant. The trade-off is being willing to accept more risk for the higher return of the innovation. More needs to be done to bring about organiza- tional change, yet progress is being made. The California DOT 2011 Peer Exchange report, “Implementing Research Results, Characteristics of Organizations and Skill Sets of Individuals Successful at Accelerating Adoption of Innova- tion,” includes perspectives on creating innovative cultures that are also more supportive of risk (California DOT 2011). Louisiana and Utah departments are particularly noteworthy for seeking to advance the culture of innovation. In a news video on AASHTO Transportation TV, Utah chief executive John Njord shows an example of the accomplishments of an innovative culture: the I-15 CORE project using accelerated bridge construction among other innovations. The culture of innovation is an intentional strategy to enhance deliv- ery of transportation products departmentwide. Moreover, communication and marketing of innovative activities bring further credibility for the department (AASHTO Transpor- tation TV 2011). Complex process: One of the understated factors is that for practitioners and research managers alike, implementation is a surprisingly complex process. Well-written documentation on the implementation process, regulations, and strategies has been produced by DoD, USDA, and others such as FLC (DoD 2005; USDA 2000; FLC 2008). Also, the National Implementation Research Network prepared a synthesis of the literature published for the behavioral health community to “describe the current state of the science in implementa- tion and identify what it will take to transmit innovative pro- grams and practices to mental health, social services, [and more]” (Fixsen et al. 2005, p. vi). Anecdotal evidence from interviews conducted for this current study confirms the complexity of implementation efforts and promotes guid- ance and best practices sharing as enablers of more effective and efficient implementation of research results. Boundary spanning: Interventions that span the gap between researcher and user contexts are being promoted by a variety of organizations. Most notable of these activities in the public sector are Partnership Intermediary Agreements

15 (PIAs) that provide a formalized role for an intermediary player between the institutions producing the research results (who have implementation and technology transfer func- tions) and the user community. PIAs supply expertise and other resources to reduce barriers in the process of imple- mentation and to speed the use of results of federal laboratory research (USDA 2009, p. 5). Likewise, the gap between aca- demic research and commercialization of research products is being filled by specialized talent that steps in to facilitate a more effective transition from researcher to developer and market. The goal of such boundary spanning is to promote collaboration between researcher and user and to produce outcomes that the individual domains could not produce as effectively without such intentional connection. A boundary spanner provides openness across the boundaries of an organization by facilitating an information exchange that alerts the system to new developments, both problems and solutions. (Rogers 2003) An additional aspect of the value of boundary-spanning activities is to further the ability to properly prioritize research needs. A tenet of implementation is to “always address a genuine need” (Bikson et al. 1996, p. 15), and a key to prioritizing needs is providing excellent communica- tion and closing the gaps that can exist among the sponsor, the researcher (or prospective researcher), and the user com- munity. Furthermore, credible champions fulfill boundary- spanning roles. Champions know the technical aspects of the need or the solution and can also communicate well among all the participants. Boundary-spanning activities can pro- mote more effective understanding of the need and supply a better understanding of the use of the research result, thus ultimately playing a role in speeding the application of the result to practice. The outcome of using boundary-spanning practices is to foster better interaction and engagement among all parties involved in the research activity, especially implementation. Incentives: Many in the business of implementation know that incentives are helpful to foster motivation for change in desired behavior. Incentives assist the organiza- tion in achieving its strategic priorities, and can be helpful when those priorities are focused on accelerating the use of research results. This type of tool is used in the public and private sectors as well as in academia, and it is accomplished through a host of vehicles. In particular, incentives are not necessarily financial rewards, although for those seeking to commercialize research results, financial rewards to the institution or the researchers and developers can be part of the practices that lead to fostering the use of innovations. Regardless of the form of the incentive, a key is tapping into what makes people excited about their work and motivates them to work more effectively at achieving success aligned with the organizational goals (Rumpel and Medcof 2006). Among many outcomes of using incentives, such rewards are an indication of management support for exemplary per- formance and serve to recognize the individual in a public manner. Incentives are often an integral part of an organiza- tion’s culture that enables an entrepreneurial atmosphere in which to foster use of innovations. Incentives must be care- fully crafted to promote desired results yet also be designed to fall within legal and regulatory limits. Incentives should be considered by organizations seeking to accelerate the application of research results as a strategic priority. Effectiveness measures: The factors discussed in this chapter affect the rate of implementation of research results, but there is little, if any, definitive work that examines the effectiveness of the practices used. In health, defense, and other domains, there is considerable awareness of the need for research into what methods are most successful, what impact the application of a specific practice yields, the cumulative effect of application of multiple practices to an implementation effort, and more. Studies, including by Rog- ers (2003) and Fixsen (2005), conclude that information dis- semination alone is an ineffective implementation tool (yet is a common practice), and Fixsen further states that train- ing by itself in human services contexts is not sufficiently effective. Such studies discuss what does not work well; however, no replicable, quantitative measures of effective- ness of direct application of strategies, methods, or tools for implementation are evident in the literature reviewed for this synthesis. Much of the difficulty of finding effectiveness of practices is the result of the “wide variation in methodology, measures, and use of terminology across studies [that] lim- its interpretation and prevents meta-analysis with regard to dissemination-diffusion and implementation studies” (Fix- sen et al. 2008, p. 1). Additionally, as noted in the recent study of the land- scape for technology transfer within the federal labora- tories, there is no quantitative information on metrics to oversee and assess effectiveness of technology transfer methods or strategies. In general, effectiveness is seen more as a subjective determination of success. It is measured not by how well individual strategies or methods perform and to what degree, but through assessment of whether the total implementation was accomplished successfully and how many incidences of such successes occurred. For example, measurement occurs as identified by greater engagement/ performance of patients or users in the clinical and behav- ioral health fields, the use of research products in domains such as energy and defense, or the number of products commercialized by the academic community. Best practices: In many cases, the application of a prac- tice successfully used by others is often considered best practice—the practice worked and accomplished the deter- mined goal. Essentially, the term “best practice” can mean

16 that it was successful, without substantive benchmarking to determine whether the practice was indeed “best.” With that caveat, use of best practices is universally endorsed by every domain and in every context within the litera- ture addressing implementation. Some domains are more advanced than others in identifying genuinely best prac- tices. The clinical and behavioral health fields, as has been discussed in this chapter, have done comprehensive work on identifying practices and have documented them for implementation guidance and training (Fixsen et al. 2005). Private-sector organizations seek to apply practices with high potential for producing timely and cost-effec- tive results. Using best practices in every stage of the new product development cycle, including implementation, is another example of the dependence on and use of adopting others’ strategies that work. Certainly the attractiveness of using best practices is to capitalize on the opportunity to reduce risk of failure for the implementing organization—applying practices that worked in a similar context has potential for similar suc- cess; to speed the implementation process along because hurdles that slowed the use of the research result have been addressed or strategies have been identified to cir- cumvent them; and to reduce cost by preventing duplica- tion of effort though not having to develop the successful implementation process. In summary, the factors discussed present the foundation for actions to accelerate the implementation of transporta- tion research results. The following chapter provides exam- ples of how these factors are incorporated into the process of implementation in various contexts.