Cost composition by implementation

Cost composition by implementation phaseFull size imageThese visuals illustrate how the proposed method produces data that provides concrete and transparent cost information for decision-makers. It can support the identification of actions with little value, causes of variation in costs, and how changing a specific component would change costs. Detailed resource composition enables decision-makers to look for the best balance among the resources allocated to the implementation strategies and to help identify places where it may be possible to reduce costs without substantially reducing effectiveness. For example, if it is apparent that travel time costs represent a large percentage of the overall cost burden, decision-makers may opt to use technology to conduct some meetings remotely rather than in person. Detailed information can also help to identify cases where it may be appropriate to shift specific tasks to less expensive personnel.DiscussionIn this study, we present a simple, pragmatic method for costing implementation strategies that combines time-driven activity-based costing, an established business accounting method, with the Proctor et al. framework, a well-known implementation science framework for specifying and reporting implementation strategies [20, 21, 23]. Blending these two approaches allows for the integration of cost estimation into an existing structure that can guide evaluations of implementation strategy effectiveness. It involves clearly mapping implementation strategies by specifying the names, actions, actors, and temporality associated with them; determining the frequency and average duration of each action associated with individual strategies; and assigning a dollar value to the resources that each action consumes. Itemization of resource use and costs is piggy-backed on the Proctor framework; specifications of actions, actors, temporality, frequency, and average duration are used to directly determine the resources utilized by the strategies and their costs. Our approach allows researchers using the Proctor rubric to estimate implementation strategy costs and routinely report them alongside the other elements of the framework.