Leveraging implementation science to solve the big problems: a scoping review of health system preparations for the effects of pandemics and climate change

As the planet warms and pandemics become more common, health systems will face disruptions to both their service delivery and their workforce. To minimise the severity of these impacts, health systems will need to efficiently and rapidly prepare, adapt, and respond. Implementation science will be crucial to the success of these actions. However, the extent to which health systems are using implementation science to address the pressures of pandemics and climate change is not currently known. In this scoping review, we aimed to address this research gap. We reviewed empirical studies that used implementation science to adapt, respond to, or prepare a health-care setting for a pandemic or climate-related event, defining components of implementation science (as proposed by Nilsen [2015]) and implementation evaluation outcomes (as proposed by Proctor and colleagues [2011]). We found a growing evidence base describing the use of implementation science in health system responses to pandemics (n=54 studies), but a dearth of similar evidence for climate change (n=2 studies). Future research could benefit from applying the principles of implementation science in pre-implementation phases and purposefully planning for long-term, ongoing evaluations, which will facilitate tailored and sustainable health system responses to climate-related and pandemic events.