Challenges, solutions and future directions in the evaluation of service innovations in health care and public health.

As the field of implementation science comprises a range of different ontological and disciplinary orientations, there is not always consensus on the boundaries of the research agenda or the challenges faced. Explicit discussion about the terminology used in the field would be useful to clarify differences in perspective and conceptual foundations. There is a need to generate an in-depth understanding of intervention design and development by considering the role of theory, the influence of context and meaningful involvement of relevant end-users. Theory-driven, pragmatic evaluation designs are proposed as a solution to produce evidence of intervention effects, and the potential of ‘implementation laboratories’ is also discussed. A balance has to be sought, however, between rigidly controlled studies and adaptive evaluations that allow emergent changes to the intervention or the implementation process through timely feedback. Practical recommendations would support the development of the field in evaluating the implementation of evidence-based practice.