scholarly journals Development and use of a toolkit to facilitate implementation of an evidence-based intervention: a descriptive case study

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Kelli Thoele ◽  
Melora Ferren ◽  
Laura Moffat ◽  
Alyson Keen ◽  
Robin Newhouse
Keyword(s):  
Implementation Strategies ◽  
Clinical Intervention ◽  
Evidence Based ◽  
Descriptive Case Study ◽  
Implementation Effectiveness ◽  
Clinical Nurses ◽  
Effective Strategies ◽  
Policies And Procedures ◽  
External Stakeholders

Abstract Background Implementation of evidence-based clinical interventions in real-world settings becomes a futile effort when effective strategies to foster adoption are not used. A toolkit, or a collection of adaptable documents to inform and facilitate implementation, can increase the use of evidence-based interventions. Most available toolkits provide resources about the intervention but lack guidance for adaptation to different contexts or strategies to support implementation. This paper describes the development and use of a toolkit to guide the implementation of an evidence-based intervention to identify and intervene for people with risky substance use. Methods A descriptive case study describes the development and use of a toolkit throughout a two-year study. Investigators and site coordinators from 14 acute care hospitals developed tools and engaged external stakeholders as they prepared for implementation, integrated the clinical intervention into practice, and reflected on implementation. Results The final toolkit included 54 different tools selected or created to define the intervention, engage and communicate with stakeholders, assess for readiness and plan for implementation, train clinical nurses and other stakeholders, evaluate training and implementation effectiveness, create policies and procedures for different contexts, and identify opportunities for reimbursement. Each tool corresponds to one or more implementation strategies. Conclusion The approach used to develop this implementation toolkit may be used to create resources for the implementation of other evidence-based interventions.

Implementation Strategies

2018 ◽  
Author(s):  
Byron J. Powell ◽  
Krystal G. Garcia ◽  
Maria E. Fernandez
Keyword(s):  
Scale Up ◽  
Research Priorities ◽  
Cancer Control ◽  
Implementation Strategies ◽  
Routine Care ◽  
The State ◽  
Evidence Based ◽  
Implementation Barriers ◽  
Research And Practice ◽  
Effective Strategies

Implementation strategies are methods or techniques that can be used to enhance the adoption, implementation, scale-up, and sustainment of evidence-based cancer control practices into routine care. This chapter defines implementation strategies, presents several taxonomies of implementation strategies that can be used to address multilevel implementation barriers, describes guidelines for reporting and specifying implementation strategies to ensure the efficient generation of knowledge and the replication of effective strategies in research and practice, briefly overviews the state of evidence for strategies, and suggests ways in which they can be carefully developed and applied to address the needs of specific contexts. The chapter concludes by presenting several research priorities related to implementation strategies.

scholarly journals Developing a Plan for the Sustainable Implementation of an Electronic Health Intervention (Partner in Balance) to Support Caregivers of People With Dementia: Case Study

JMIR Aging ◽  
10.2196/18624 ◽  
2020 ◽  
Vol 3 (1) ◽  
pp. e18624
Author(s):  
Hannah Liane Christie ◽  
Lizzy Mitzy Maria Boots ◽  
Kirsten Peetoom ◽  
Huibert Johannes Tange ◽  
Frans Rochus Josef Verhey ◽  
...  
Keyword(s):  
Health Care ◽  
Business Model ◽  
Implementation Strategies ◽  
Evidence Based ◽  
Implementation Plan ◽  
Dementia Case ◽  
People With Dementia ◽  
Electronic Health ◽  
Ehealth Intervention

Background Given the increasing use of digital interventions in health care, understanding how best to implement them is crucial. However, evidence on how to implement new academically developed interventions in complex health care environments is lacking. This case study offers an example of how to develop a theory-based implementation plan for Partner in Balance, an electronic health (eHealth) intervention to support the caregivers of people with dementia. Objective The specific objectives of this study were to (1) formulate evidence-based implementation strategies, (2) develop a sustainable business model, and (3) integrate these elements into an implementation plan. Methods This case study concerns Partner in Balance, a blended care intervention to support the caregivers of people with dementia, which is effective in improving caregiver self-efficacy, quality of life, and experienced control. The large-scale implementation of Partner in Balance took place in local dementia case-management services, local care homes, dementia support groups, and municipalities. Experiences from real-life pilots (n=22) and qualitative interviews with national stakeholders (n=14) were used to establish an implementation plan consisting of implementation strategies and a business model. Results The main finding was the need for a business model to facilitate decision-making from potential client organizations, who need reliable pricing information before they can commit to training coaches and implementing the intervention. Additionally, knowledge of the organizational context and a wider health care system are essential to ensure that the intervention meets the needs of its target users. Based on these findings, the research team formulated implementation strategies targeted at the engagement of organizations and staff, dissemination of the intervention, and facilitation of long-term project management in the future. Conclusions This study offers a theory-based example of implementing an evidence-based eHealth intervention in dementia health care. The findings help fill the knowledge gap on the eHealth implementation context for evidence-based eHealth interventions after the trial phase, and they can be used to inform individuals working to develop and sustainably implement eHealth.

scholarly journals Perceptions of the Barriers, Facilitators, Outcomes, and Helpfulness of Strategies to Implement Screening, Brief Intervention, and Referral to Treatment in Acute Care

2021 ◽  
Author(s):  
Alyson Keen ◽  
Kelli M Thoele ◽  
Ukamaka Oruche ◽  
Robin Newhouse
Keyword(s):  
Acute Care ◽  
Brief Intervention ◽  
Qualitative Data ◽  
Implementation Strategies ◽  
Implementation Process ◽  
Clinical Intervention ◽  
Structured Interview ◽  
Evidence Based ◽  
Positive Health

Abstract Background: Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based clinical intervention used to reduce alcohol and illicit drug use. SBIRT use has resulted in positive health and social outcomes; however, SBIRT implementation remains low. Research on implementing evidence-based interventions, such as SBIRT, lacks information about challenges and successes related to implementation. The Expert Recommendations for Implementing Change (ERIC) provides a framework to guide comprehension, clarity, and relevance of strategies available for implementation research. This framework was applied to qualitative feedback gathered from site coordinators (SCs) leading SBIRT implementation. The purpose of this study was to describe the SCs’ experiences pertaining to SBIRT implementation across a health system. Methods: Within the context of a larger parent study, a semi-structured interview guide was used to capture 14 SCs’ perceptions of the barriers, facilitators, and outcomes pertaining to SBIRT implementation. This qualitative data was analyzed using standard content analytic procedures. A follow-up survey was developed based on 14 ERIC strategies identified from qualitative data and was administered electronically to determine the SC’s perceptions of the most helpful implementation strategies on a scale of 1 (least helpful) to 5 (most helpful). Results: All 14 invited SCs participated in the SBIRT implementation interview, and 11 of 14 (79%) responded to the follow-up survey. Within the categories of barriers, facilitators, and outcomes, 25 subthemes emerged. The most helpful ERIC implementation strategies were purposely reexamining the implementation (M=4.38; n=8), providing ongoing consultation (M=4.13; n=8), auditing and providing feedback (M=4.1; n=10), developing education materials (M=4.1; n=10), identifying and preparing champions (M=4; n=7), and tailoring strategies (M=4; n=7). Conclusion: SCs who led implementation efforts within a large healthcare system identified several barriers and facilitators to the implementation of SBIRT. Additionally, they identified clinician-related outcomes associated with SBIRT implementation into practice as well as strategies that were helpful in the implementation process. This information can inform the implementation of SBIRT and other interventions in acute care settings.

Hemostatic Strategies in Trauma

2021 ◽  
Vol 32 (1) ◽  
pp. 51-63
Author(s):  
Paul Thurman
Keyword(s):  
Traumatic Injury ◽  
Early Death ◽  
Evidence Based ◽  
Laboratory Studies ◽  
Case Study Approach ◽  
Study Approach ◽  
Effective Strategies ◽  
Trauma Induced Coagulopathy ◽  
Severe Traumatic Injury

Bleeding is a leading cause of early death from trauma. Consequently, effective hemostasis can improve the odds of survival after severe traumatic injury. Understanding the pathophysiology of trauma-induced coagulopathy can provide insights into effective strategies to assess and halt hemorrhage. Both physical assessment and appropriate laboratory studies are important in the diagnosis and evaluation of coagulopathy to identify the most effective mechanical and pharmacological strategies to achieve hemostasis. This article uses a case study approach to explore evidence-based techniques to evaluate hemorrhage and strategies to promote hemostasis.

The FluFIT Program

2018 ◽  
Author(s):  
Michael B. Potter ◽  
Debbie Kirkland ◽  
Judith M. E. Walsh ◽  
Carol P. Somkin ◽  
Vicky Gomez ◽  
...  
Keyword(s):  
San Francisco ◽  
Stakeholder Engagement ◽  
Clinical Intervention ◽  
The United States ◽  
Design Evaluation ◽  
Dissemination And Implementation ◽  
Clinical Settings ◽  
Evidence Based ◽  
Pilot Program

The FluFIT program is an evidence-based intervention that leverages the time of annual influenza vaccination activities as an opportunity to offer colorectal cancer screening with fecal immunochemical testing to eligible adults between the ages of 50 and 75 years. Begun as a pilot program for a family medicine residency-based flu shot clinic in San Francisco in 2005, the FluFIT program has since been evaluated and implemented successfully in a wide variety of clinical settings throughout the United States. This case study describes the process of designing and testing a clinical intervention with the goal of implementation. Important steps included an initial needs assessment identifying the capabilities and opportunities for changing the behavior of clinical teams, as well as broadly conceived and continuously sustained stakeholder engagement at all stages of program design, evaluation, dissemination, and implementation.

scholarly journals Developing a Plan for the Sustainable Implementation of an Electronic Health Intervention (Partner in Balance) to Support Caregivers of People With Dementia: Case Study (Preprint)

2020 ◽  
Author(s):  
Hannah Liane Christie ◽  
Lizzy Mitzy Maria Boots ◽  
Kirsten Peetoom ◽  
Huibert Johannes Tange ◽  
Frans Rochus Josef Verhey ◽  
...  
Keyword(s):  
Health Care ◽  
Business Model ◽  
Implementation Strategies ◽  
Evidence Based ◽  
Implementation Plan ◽  
Dementia Case ◽  
People With Dementia ◽  
Electronic Health ◽  
Ehealth Intervention

BACKGROUND Given the increasing use of digital interventions in health care, understanding how best to implement them is crucial. However, evidence on how to implement new academically developed interventions in complex health care environments is lacking. This case study offers an example of how to develop a theory-based implementation plan for Partner in Balance, an electronic health (eHealth) intervention to support the caregivers of people with dementia. OBJECTIVE The specific objectives of this study were to (1) formulate evidence-based implementation strategies, (2) develop a sustainable business model, and (3) integrate these elements into an implementation plan. METHODS This case study concerns Partner in Balance, a blended care intervention to support the caregivers of people with dementia, which is effective in improving caregiver self-efficacy, quality of life, and experienced control. The large-scale implementation of Partner in Balance took place in local dementia case-management services, local care homes, dementia support groups, and municipalities. Experiences from real-life pilots (n=22) and qualitative interviews with national stakeholders (n=14) were used to establish an implementation plan consisting of implementation strategies and a business model. RESULTS The main finding was the need for a business model to facilitate decision-making from potential client organizations, who need reliable pricing information before they can commit to training coaches and implementing the intervention. Additionally, knowledge of the organizational context and a wider health care system are essential to ensure that the intervention meets the needs of its target users. Based on these findings, the research team formulated implementation strategies targeted at the engagement of organizations and staff, dissemination of the intervention, and facilitation of long-term project management in the future. CONCLUSIONS This study offers a theory-based example of implementing an evidence-based eHealth intervention in dementia health care. The findings help fill the knowledge gap on the eHealth implementation context for evidence-based eHealth interventions after the trial phase, and they can be used to inform individuals working to develop and sustainably implement eHealth.

scholarly journals HOW TO DO IT? COMMUNICATION FOR MANAGING CAFE IN PEKALONGAN

ICCD ◽  
2019 ◽  
Vol 2 (1) ◽  
pp. 235-238
Author(s):  
Irmawan Rahyadi ◽  
Riyanto Jayadi ◽  
Hanggoro Pamungkas
Keyword(s):  
Community Development ◽  
Small Group ◽  
Development Project ◽  
Communication Process ◽  
Space Communication ◽  
Application System ◽  
Descriptive Case Study ◽  
External Stakeholders ◽  
Rural Part

Communication in cafe between workers serving customers shaped according to a system set preliminary to launching the space. Communication in order to deliver orders to service table is challenged when certain scenarios introduce to the dynamics between workers. This article discusses the view of communication for managing cafe in Pekalongan. The skills involved in managing cafe include cashier application system, simple accounting and tax. Communication as an integral part which intertwined all the cashier, waiter, cook and customer in routine process of a cafe. Today, cafe flourishing all over Indonesia including some rural part of the country encourage skills to be adapted by managing party to run day to day activities. Pekalongan with its natural assets opens opportunities to bring up human assets especially youth and productive age level in rural Indonesia. Descriptive case study is applied in this article where a small group of trainees of youth and PKK members observed as sample. In order to understand how management cafe can be instilled as an applicable skill, community development project in Pekalongan is studied. This article revealed supporting findings to contribute to practical and academic conversation which shows that certain scenarios exercises beneficial in comprehension of communication between cafe personnel and customers. This insight gave us a clearer portrait of how communication is an essential part of workplace positive dynamics especially when external stakeholders are involved in the communication process.

Misophonia: An Evidence-Based Case Report

2020 ◽  
Vol 29 (4) ◽  
pp. 685-690
Author(s):  
C. S. Vanaja ◽  
Miriam Soni Abigail
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Case History ◽  
Pure Tone ◽  
Physiological Responses ◽  
Evidence Based ◽  
Management Option ◽  
Pure Tone Audiogram

Purpose Misophonia is a sound tolerance disorder condition in certain sounds that trigger intense emotional or physiological responses. While some persons may experience misophonia, a few patients suffer from misophonia. However, there is a dearth of literature on audiological assessment and management of persons with misophonia. The purpose of this report is to discuss the assessment of misophonia and highlight the management option that helped a patient with misophonia. Method A case study of a 26-year-old woman with the complaint of decreased tolerance to specific sounds affecting quality of life is reported. Audiological assessment differentiated misophonia from hyperacusis. Management included retraining counseling as well as desensitization and habituation therapy based on the principles described by P. J. Jastreboff and Jastreboff (2014). A misophonia questionnaire was administered at regular intervals to monitor the effectiveness of therapy. Results A detailed case history and audiological evaluations including pure-tone audiogram and Johnson Hyperacusis Index revealed the presence of misophonia. The patient benefitted from intervention, and the scores of the misophonia questionnaire indicated a decrease in the severity of the problem. Conclusions It is important to differentially diagnose misophonia and hyperacusis in persons with sound tolerance disorders. Retraining counseling as well as desensitization and habituation therapy can help patients who suffer from misophonia.

Treatment Considerations for Adolescents Who Exhibit Cognitive/Communication Problems: A Neuroscience Perspective

2020 ◽  
Vol 5 (6) ◽  
pp. 1767-1775
Author(s):  
Martha S. Burns
Keyword(s):  
Social Communication ◽  
Transition Period ◽  
Clinical Intervention ◽  
Review Article ◽  
Sensitive Period ◽  
Clinical Implications ◽  
Evidence Based ◽  
Communication Problems ◽  
Treatment Considerations ◽  
Behavioral Growth

Purpose Adolescence is a period of substantial neurophysiological and behavioral growth, representing a second sensitive period of brain development. It is a psychological and social transition period between childhood and adulthood with many beneficial changes occurring, especially with respect to potential responsiveness to clinical intervention. However, adolescent behavioral complexities introduce clinical challenges as well. The purpose of this review article is to review the current neuroimaging research on neurophysiological changes observed during adolescence and the cognitive and social behavioral counterparts, with specific attention to the clinical implications. The review article will then summarize currently available intervention tools that can be utilized by speech-language pathologists working with this population. It will conclude with available evidence-based social-communication approaches that may be applicable as well as available evidence-based supplemental technological cognitive interventions that may be useful in working with adolescents who exhibit language and communication issues. Conclusion As a transition period between childhood and adulthood, adolescence represents a second sensitive period during which there is opportunity for clinically derived beneficial cognitive and communication growth.

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