Early in my career as a neonatologist, group B streptococcus (GBS) was one of the infections we feared most. Babies who appeared healthy could become critically ill within hours or days, leaving physicians to tell parents that their newborn was suddenly fighting a life-threatening infection.

Eventually, evidence gave us a way to prevent many of those infections. Researchers found that screening pregnant women for GBS, and treating those who tested positive with antibiotics during labor could dramatically reduce transmission to newborns. Professional societies issued recommendations. But practice did not change overnight.

It took years of clearer guidelines, physician education, and standardized workflows before universal GBS screening became embedded into routine prenatal care. I spent much of my career developing and implementing evidence-based guidelines across neonatal and population health programs. That experience taught me something healthcare needs to pay more attention to today: A guideline can tell clinicians what good care looks like, but on its own it cannot make that care happen.

That matters as medicine advances faster than our healthcare system’s ability to incorporate those advances into everyday practice.

Clinical research asks whether a diagnostic or treatment works. Implementation science asks what happens next: If we know something works, what will it take to make sure patients receive it?

GBS screening offers useful lessons. Early recommendations gave clinicians multiple approaches. Over time, guidance became more decisive and universal screening became the standard. But guidelines were only part of what changed.

Healthcare built a reliable system around them. The recommendation became a workflow.

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