TY - JOUR
T1 - The road to successful implementation of innovation in radiotherapy
T2 - A research-based implementation protocol
AU - Ho, Fiona
AU - Swart, Rachelle
AU - Boersma, Liesbeth
AU - Fijten, Rianne
AU - Cremers, Paul
AU - van Merode, Frits
AU - Jacobs, Maria
AU - Alongi, Filippo
AU - Belderbos, José
AU - Bhattacharya, Indrani S.
AU - Buijsen, Jeroen
AU - van Dieren, Erik
AU - Dirkx, Maarten L.P.
AU - van der Geest, Annelies M.
AU - Grau, Cai
AU - Guckenberger, Matthias
AU - Houweling, Anette C.
AU - Jereczek-Fossa, Barbara A.
AU - Jetten, Leo
AU - Kleijnen, Jean Paul J.E.
AU - Koetsveld, Folkert
AU - Koppe, Frederieke
AU - Krol, Augustinus D.G.
AU - de Langen, Mark
AU - Langendijk, Johannes A.
AU - Lievens, Yolande
AU - Mast, Mirjam E.
AU - Meattini, Icro
AU - Bas Nijsten, S. M.J.J.G.
AU - Peters, Nadina
AU - Poortmans, Philip
AU - Scorsetti, Marta
AU - Slotman, Ben J.
AU - Troost, Esther
AU - Ulehake, Marike
AU - Vandemaele, Miet
AU - Venema-Spoelder, Jose
AU - Veninga, Theo
AU - Verheij, Marcel
AU - Walters, Bethany Hipple
AU - Sandra de Wringer - van Vliet, A. S.
AU - Collaborative expert group implementation protocol for radiotherapy innovations
AU - Nijsten, Bas
N1 - Publisher Copyright:
© 2025 The Author(s)
PY - 2025/6/1
Y1 - 2025/6/1
N2 - 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.
AB - 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.
KW - Delphi study
KW - Implementation protocol
KW - Implementation science
KW - Innovation
KW - Knowledge-to-Action
KW - Radiotherapy
U2 - 10.1016/j.radonc.2025.110874
DO - 10.1016/j.radonc.2025.110874
M3 - Article
SN - 0167-8140
VL - 207
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
M1 - 110874
ER -