Implementation Support Skills: Findings From a Systematic Integrative Review

2020 ◽  
pp. 104973152096741
Author(s):  
Bianca Albers ◽  
Allison Metz ◽  
Katie Burke ◽  
Leah Bührmann ◽  
Leah Bartley ◽  
...  
Keyword(s):  
Social Services ◽  
Implementation Strategies ◽  
Integrative Review ◽  
Implementation Support ◽  
Implementing Change ◽  
Support Strategies ◽  
Local Contexts ◽  
Agents Of Change ◽  
Support Skills ◽  
Expert Recommendations

Purpose: Skills in selecting and designing strategies for implementing research-supported interventions (RSIs) within specific local contexts are important for progressing a wider RSI adoption and application in human and social services. This also applies to a particular role in implementation, the implementation support practitioner (ISP). This study examines which strategies have been reported as being used by ISPs across multiple bodies of research on implementation support and how these strategies were applied in concrete practice settings. Methods: A systematic integrative review was conducted. Data analysis utilized the Expert Recommendations for Implementing Change compilation of implementation strategies. Results: Studies reported on 18 implementation strategies commonly used by different ISPs, who require mastery in selecting, operationalizing, and detailing these. Two further strategies not included in the ERIC compilation could be identified. Discussion: Given the use of primarily more feasible implementation support strategies among ISPs, their potential as agents of change may be underutilized.

scholarly journals A refined compilation of implementation strategies: results from the Expert Recommendations for Implementing Change (ERIC) project

2015 ◽  
Vol 10 (1) ◽  
Author(s):  
Byron J Powell ◽  
Thomas J Waltz ◽  
Matthew J Chinman ◽  
Laura J Damschroder ◽  
Jeffrey L Smith ◽  
...  
Keyword(s):  
Implementation Strategies ◽  
Implementing Change ◽  
Expert Recommendations

scholarly journals Strategies to Integrate Genomic Medicine into Clinical Care: Evidence from the IGNITE Network

2021 ◽  
Vol 11 (7) ◽  
pp. 647
Author(s):  
Nina R. Sperber ◽  
Olivia M. Dong ◽  
Megan C. Roberts ◽  
Paul Dexter ◽  
Amanda R. Elsey ◽  
...  
Keyword(s):  
Precision Medicine ◽  
Program Implementation ◽  
Clinical Care ◽  
Genomic Medicine ◽  
Implementation Strategies ◽  
Clinical Decision ◽  
Implementing Change ◽  
Implementation Outcomes ◽  
Planning Framework

The complexity of genomic medicine can be streamlined by implementing some form of clinical decision support (CDS) to guide clinicians in how to use and interpret personalized data; however, it is not yet clear which strategies are best suited for this purpose. In this study, we used implementation science to identify common strategies for applying provider-based CDS interventions across six genomic medicine clinical research projects funded by an NIH consortium. Each project’s strategies were elicited via a structured survey derived from a typology of implementation strategies, the Expert Recommendations for Implementing Change (ERIC), and follow-up interviews guided by both implementation strategy reporting criteria and a planning framework, RE-AIM, to obtain more detail about implementation strategies and desired outcomes. We found that, on average, the three pharmacogenomics implementation projects used more strategies than the disease-focused projects. Overall, projects had four implementation strategies in common; however, operationalization of each differed in accordance with each study’s implementation outcomes. These four common strategies may be important for precision medicine program implementation, and pharmacogenomics may require more integration into clinical care. Understanding how and why these strategies were successfully employed could be useful for others implementing genomic or precision medicine programs in different contexts.

scholarly journals Developing implementation strategies to adopt Enhanced Recovery After Surgery (ERAS®) guidelines

BJS Open ◽  
2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Jennifer Y Lam ◽  
Alexandra Howlett ◽  
Duncan McLuckie ◽  
Lori M Stephen ◽  
Scott D N Else ◽  
...  
Keyword(s):  
Implementation Strategy ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Healthcare Providers ◽  
Implementation Strategies ◽  
Multidisciplinary Teams ◽  
Successful Implementation ◽  
Care Pathways ◽  
Audit System ◽  
Local Contexts

Abstract Background Strong implementation strategies are critical to the success of Enhanced Recovery after Surgery (ERAS®) guidelines, though little documentation exists on effective strategies, especially in complex clinical situations and unfamiliar contexts. This study outlines the process taken to adopt a novel neonatal ERAS® guideline. Methods The implementation strategy was approached in a multi-pronged, concurrent but asynchronous fashion. Between September 2019 and January 2020, healthcare providers from various disciplines and different specialties as well as parents participated in the strategy. Multidisciplinary teams were created to consider existing literature and local contexts including potential facilitators and/or barriers. Task forces worked collaboratively to develop new care pathways. An audit system was developed to record outcomes and elicit feedback for revision. Results 32 healthcare providers representing 9 disciplines and 5 specialties as well as 8 parents participated. Care pathways and resources were created. Elements recommended for a successful implementation strategy included identification of champions, multidisciplinary stakeholder involvement, consideration of local contexts and insights, patient/family engagement, education, and creation of an audit system. Conclusion A multidisciplinary and structured process following principles of implementation science was used to develop an effective implementation strategy for initiating ERAS® guidelines.

scholarly journals Coaches’ implementation strategies in providing social support to Singaporean university athletes: A case study

2019 ◽  
Vol 14 (5) ◽  
pp. 681-693
Author(s):  
Koon Teck Koh ◽  
Marja Kokkonen ◽  
Heng Rang Bryan Law
Keyword(s):  
Social Support ◽  
Implementation Strategies ◽  
Well Being ◽  
Implementation Framework ◽  
Support Strategies ◽  
Individual Sports ◽  
Sport Coaches ◽  
University Athletes

Coaches are effective providers of social support to their athletes. Although sport-specific measures of social support have been developed to better understand athletes’ perceptions of available support, limited amount of research has addressed how sport coaches implement specific social support strategies. The purpose of this study was to examine university coaches’ implementation strategies in providing various forms of social support to their athletes. A total of eight sport coaches from team and individual sports (four from each sport) were purposefully selected for this study. Coaches were individually interviewed. The interview transcripts were analysed using a thematic analysis. The results revealed that coaches from different sports shared similar strategies across emotional, esteem, informational and tangible dimensions, but with some distinguishable differences in the way these strategies were implemented. In documenting the lived experiences of sport coaches, key strategies valued highly among these coaches were highlighted, providing important implications for coaches to know how to incorporate these strategies into their coaching practice to better support athletes’ well-being and improve the quality of coaching. The findings also provide an implementation framework of social support that emphasizes key strategies for coaches to focus on in their coaching approaches.

scholarly journals Extent, Type and Reasons for Adaptation and Modification When Scaling-Up an Effective Physical Activity Program: Physical Activity 4 Everyone (PA4E1)

2021 ◽  
Author(s):  
Matthew Mclaughlin ◽  
Elizabeth Campbell ◽  
Rachel Sutherland ◽  
Tom McKenzie ◽  
Lynda Davies ◽  
...  
Keyword(s):  
Physical Activity ◽  
Program Effectiveness ◽  
Negative Impact ◽  
Positive Impact ◽  
Scale Up ◽  
Evaluation Methods ◽  
Physical Activity Program ◽  
Implementation Support ◽  
Support Strategies ◽  
Activity Program

Abstract Background Few studies have described the extent, type and reasons for making changes to a program prior to and during its delivery using a consistent taxonomy. Physical Activity 4 Everyone (PA4E1) is a secondary school physical activity program that was scaled-up for delivery to a greater number of schools. We aimed to describe the extent, type and reasons for changes to the PA4E1 program (the evidence-based physical activity practices, implementation support strategies and evaluation methods) made before its delivery at scale (adaptations) and during its delivery in a scale-up trial (modifications). Methods The Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) was used to describe adaptations (planned and made prior to the scale-up trial) and modifications (made during the conduct of the trial). A list of adaptations was generated from a comparison of the efficacy and scale-up trials via published PA4E1 protocols, trial registrations and information provided by trial investigators. Monthly trial team meetings tracked and coded modifications in ‘real-time’ during the conduct of the scale-up trial. The extent, type and reasons for both adaptations and modifications were summarized descriptively. Results In total, 20 adaptations and 20 modifications were identified, these were to physical activity practices (n = 8; n = 3), implementation support strategies (n = 6; n = 16) and evaluation methods (n = 6, n = 1), respectively. Few adaptations were ‘fidelity inconsistent’ (n = 2), made ‘unsystematically’ (n = 1) and proposed to have a ‘negative’ impact on the effectiveness of the program (n = 1). Reasons for the adaptations varied. Of the 20 modifications, all were ‘fidelity consistent’ and the majority were made ‘proactively’ (n = 12), though most were ‘unsystematic’ (n = 18). Fifteen of the modifications were thought to have a ‘positive’ impact on program effectiveness. The most common decision-maker in the modification process was the ‘program manager’ (n = 17). The main reason for modification was the ‘available resources’ (n = 14) of the PA4E1 Implementation Team. For both adaptations and modifications respectively, the most common goal was to ‘improve fit with recipients’ (n = 8; n = 7). Conclusions A considerable number of adaptations and modifications were made for scale-up that could have important impacts on intervention effects and are important to the interpretation of trial findings. Trial Registration Australia New Zealand Clinical Trial Registry: ACTRN12617000681358

scholarly journals Supporting the implementation of guidelines to prevent mother-to-child-transmission of HIV in Malawi: a multi-case study

2021 ◽  
Vol 33 (3) ◽  
pp. 178-185
Author(s):  
Chifundo Zimba ◽  
Gwen Sherwood ◽  
Barbara Mark ◽  
Jeenifer Leeman
Keyword(s):  
Contextual Factors ◽  
Interactive Systems ◽  
Dissemination And Implementation ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Implementation Support ◽  
Low Resource ◽  
Support Strategies ◽  
Mother To Child

BackgroundHigh HIV infection and fertility rates contributed to over 12,000 children acquiring HIV from their mothers in 2011 in Malawi. To prevent mother-to-child transmission of HIV, Malawi adopted the Option B+ guidelines, and for three years, the University of North Carolina (UNC) Project provided support to strengthen guideline implementation in 134 health centres. Little is known about how implementation support strategies are delivered in low resource countries or contextual factors that may influence their delivery. The limited descriptions of support strategies and salient contextual factors limits efforts to replicate, target, and further refine strategies. Guided by the Interactive Systems Framework for Dissemination and Implementation, this study describes factors influencing implementation of support strategies and how they impacted health center staff capacity to implement Option B+ in Malawi. MethodsA qualitative multi-case study design was applied. Data were collected through site visits to 4 heath centres (2 low- and 2-high performing centres). We interviewed 18 support providers and recipients between October 2014 and October 2015. Data were analysed using content, thematic, and cross-case analysis.ResultsFour categories of strategies were used to support Option B+ guidelines implementation: training, technical assistance (TA), tools, and resources. All heath-centres implemented Option B+ guidelines for care provided between the antenatal and labor and delivery periods. Gaps in Option B+ implementation occurred during community activities and during post-delivery care, including gaps in testing of children to ascertain their HIV status at 6 weeks, 12 months, and 24 months. Salient contextual factors included staffing shortages, transportation challenges, limited space and infrastructure, limited stocks of HIV testing kits, and large patient populations.ConclusionsUnderstanding factors that influence implementation support strategies and delivery of the Option B+ guidelines, such as availability of staff and other materials/drug resources, is critical to designing effective implementation support for low resource settings.

Challenges for the disaster workforce during a compound hurricane–pandemic

2021 ◽  
Vol 19 (7) ◽  
pp. 9-18
Author(s):  
Jennifer Marshall, PhD, MPH, CPH ◽  
Juita-Elena (Wie) Yusuf, PhD ◽  
Elizabeth Dunn, MPH, CPH ◽  
Kelsey Merlo, PhD ◽  
Joshua G. Behr, PhD ◽  
...  
Keyword(s):  
Emergency Management ◽  
Nonprofit Organizations ◽  
Social Services ◽  
Planning Process ◽  
Effective Means ◽  
Health Resources ◽  
Management Planning ◽  
Support Strategies ◽  
Emergency Management Planning ◽  
State And Local

The COVID-19 pandemic has created new workforce considerations for emergency management community in addressing cumulative and cascading disasters. This research identifies how emergency management planning for both the changing dynamics of COVID-19 and the upcoming hurricane season may change under a compound threat. Many jurisdictions have faced challenges in providing adequate staffing of shelters before the pandemic. Now, fatigue among staff further exacerbates these challenges as resources are stretched thin. Six workshops, involving 265 national, state, and local leaders, staff, experts, and advocates from 22 states, and a range of disciplines (disaster planning, public health, social services, academia, and healthcare), were convened to identify concerns and potential strategies to address staffing, training, logistics, and support. Strategies proposed to increase the number and skill set of staff available involve increased reliance upon volunteers and nonprofit organizations. Mental health resources, personal protective equipment, sanitation supplies, and defining roles within emergency shelters were recommended to reduce fatigue and redistribute responsibilities. Findings illuminate additional research avenues regarding assessing the underlying stressors contributing to the planning process and effective means of implementing these interventions to bolster emergency management shelter operations during a prolonged pandemic and in the future.

scholarly journals The Contribution of Student Leadership to School Transformation

2013 ◽  
Vol 1 (1) ◽  
pp. 123-141
Author(s):  
Malcolm Groves ◽  
Malcolm Groves
Keyword(s):  
Stakeholder Engagement ◽  
Student Leadership ◽  
Case Study Research ◽  
Leadership Role ◽  
School Transformation ◽  
Improvement Strategy ◽  
Implementing Change ◽  
Agents Of Change

This paper reports preliminary findings from case study research in three English secondary schools where a new or recently appointed head has incorporated stakeholder engagement as a key part of their improvement strategy. In each school, developments initiated independently by each head in relation to student leadership are reported. These appear to be re-thinking the boundaries of current practice in relation to student voice, particularly with respect to developing the leadership role of students as agents of change and in beginning to extend that beyond the school into their communities.The research focuses on seeking to understand the processes of change in each case. The models and practices adopted by each head in implementing change are analysed and the effects of this experience, as reported by the students, are considered. Initial findings highlight factors that appear to contribute to successful developments, and the paper concludes with suggestions for further research and investigation to confirm this. KeywordsStudent voice, student leadership, stakeholder engagement, school transformation

scholarly journals A Strategy Matching Tool for Boosting Implementation of Geriatric Telehealth Services in Rural CBOCs

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 120-120
Author(s):  
Laura Kernan ◽  
Eileen Dryden ◽  
Camilla Pimentel ◽  
Kathryn Nearing ◽  
Lauren Moo
Keyword(s):  
Change Implementation ◽  
Outpatient Clinics ◽  
Veterans Administration ◽  
Community Based ◽  
Hub And Spoke ◽  
Implementing Change ◽  
Medical Centers ◽  
Implementation Approach ◽  
Facilitators And Barriers ◽  
Expert Recommendations

Abstract Fifteen Veterans Administration Medical Centers (VAMCs) offer geriatric specialty care telehealth services through a hub and spoke model to patients at affiliated community-based outpatient clinics (CBOCs). These services are not used to the extent they could be. Through interviews with 50 staff and providers at rural CBOCs we identified several implementation facilitators and barriers. CBOC-level barriers included space constraints, low staffing, internet connection issues, and limited knowledge of services available and referral processes. Patient-level barriers included discomfort with technology, cognitive decline, and inability to travel to the CBOC. We found that champions within the CBOC and iterative, targeted outreach from the hub helped facilitate uptake of services. We entered the identified barriers into the CFIR-ERIC (Consolidated Framework for Implementation Research-Expert Recommendations for Implementing Change) Implementation Strategy Matching Tool to help generate targeted strategies that will be used to refine each hub’s implementation approach.

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