scholarly journals Virtual external implementation facilitation: successful methods for remotely engaging groups in quality improvement

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Christine W. Hartmann ◽  
Ryann L. Engle ◽  
Camilla B. Pimentel ◽  
Whitney L. Mills ◽  
Valerie A. Clark ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Improvement ◽  
Evidence Based ◽  
National Program ◽  
Extensive Experience ◽  
Evidence Based Practices ◽  
Team Members ◽  
Virtual Experience ◽  
Key Points ◽  
Program Content

Abstract Background Relatively little guidance exists on how to use virtual implementation facilitation to successfully implement evidence-based practices and innovations into clinical programs. Yet virtual methods are increasingly common. They have potentially wider reach, emergent public health situations necessitate their use, and restrictions on resources can make them more attractive. We therefore outline a set of principles for virtual external implementation facilitation and a series of recommendations based on extensive experience successfully using virtual external implementation facilitation in a national program. Model and recommendations Success in virtual external implementation facilitation may be achieved by facilitators applying three overarching principles: pilot everything, incorporate a model, and prioritize metacognition. Five practical principles also help: plan in advance, communicate in real time, build relationships, engage participants, and construct a virtual room for participants. We present eight concrete suggestions for enacting the practical principles: (1) assign key facilitation roles to facilitation team members to ensure the program runs smoothly; (2) create small cohorts of participants so they can have meaningful interactions; (3) provide clarity and structure for all participant interactions; (4) structure program content to ensure key points are described, reinforced, and practiced; (5) use visuals to supplement audio content; (6) build activities into the agenda that enable participants to immediately apply knowledge at their own sites, separate from the virtual experience; (7) create backup plans whenever possible; and (8) engage all participants in the program. Summary These principles represent a novel conceptualization of virtual external implementation facilitation, giving structure to a process that has been, to date, inadequately described. The associated actions are demonstrably useful in supporting the principles and offer teams interested in virtual external implementation facilitation concrete methods by which to ensure success. Our examples stem from experiences in healthcare. But the principles can, in theory, be applied to virtual external implementation facilitation regardless of setting, as they and the associated actions are not setting specific.

A Model for Sustaining Evidence-Based Practices in a Statewide System

2017 ◽  
Vol 98 (1) ◽  
pp. 18-26 ◽  
Author(s):  
Jason M. Lang ◽  
Kellie G. Randall ◽  
Michelle Delaney ◽  
Jeffrey J. Vanderploeg
Keyword(s):  
Public Health ◽  
Cognitive Behavioral Therapy ◽  
Quality Indicators ◽  
Behavioral Therapy ◽  
Health Impact ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
The Public ◽  
The Past ◽  
Large Systems

Over the past 20 years, efforts have been made to broadly disseminate evidence-based practices (EBPs). However, the public health impact of EBPs has yet to be realized and most EBPs are not sustained. Few structured models exist for disseminating and sustaining EBPs across large systems. This article describes the EBP Dissemination and Support Center (DSC) model and how it was used to sustain trauma-focused cognitive behavioral therapy (TF-CBT) across Connecticut. More than 600 clinicians at 35 agencies have been trained and nearly all agencies have sustained TF-CBT for up to 9 years. More than 6,200 children have received TF-CBT and have shown improvements in outcomes and quality indicators. Recommendations are made for using or adapting the DSC model.

scholarly journals Addressing College Drinking as a Statewide Public Health Problem: Key Findings From the Maryland Collaborative

2017 ◽  
Vol 19 (2) ◽  
pp. 303-313 ◽  
Author(s):  
Amelia M. Arria ◽  
David H. Jernigan
Keyword(s):  
Public Health ◽  
Health Problem ◽  
Public Health Problem ◽  
College Drinking ◽  
Evidence Based ◽  
Student Survey ◽  
Evidence Based Practices ◽  
Research Attention ◽  
Individual Level ◽  
High Risk Drinking

Excessive drinking among college students is a serious and pervasive public health problem. Although much research attention has focused on developing and evaluating evidence-based practices to address college drinking, adoption has been slow. The Maryland Collaborative to Reduce College Drinking and Related Problems was established in 2012 to bring together a network of institutions of higher education in Maryland to collectively address college drinking by using both individual-level and environmental-level evidence-based approaches. In this article, the authors describe the findings of this multilevel, multicomponent statewide initiative. To date, the Maryland Collaborative has succeeded in providing a forum for colleges to share knowledge and experiences, strengthen existing strategies, and engage in a variety of new activities. Administration of an annual student survey has been useful for guiding interventions as well as evaluating progress toward the Maryland Collaborative’s goal to measurably reduce high-risk drinking and its radiating consequences on student health, safety, and academic performance and on the communities surrounding college campuses. The experiences of the Maryland Collaborative exemplify real-world implementation of evidence-based approaches to reduce this serious public health problem.

scholarly journals Fostering More-Effective Public Health by Identifying Administrative Evidence-Based Practices

2012 ◽  
Vol 43 (3) ◽  
pp. 309-319 ◽  
Author(s):  
Ross C. Brownson ◽  
Peg Allen ◽  
Kathleen Duggan ◽  
Katherine A. Stamatakis ◽  
Paul C. Erwin
Keyword(s):  
Public Health ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Effective Public Health ◽  
Administrative Evidence

scholarly journals Making evidence and policy in public health emergencies: lessons from COVID-19 for adaptive evidence-making and intervention

2020 ◽  
Vol 16 (3) ◽  
pp. 477-490 ◽  
Author(s):  
Kari Lancaster ◽  
Tim Rhodes ◽  
Marsha Rosengarten
Keyword(s):  
Public Health ◽  
Rapid Assessment ◽  
Social Practices ◽  
Knowledge Generation ◽  
Evidence Based ◽  
Multiple Forms ◽  
Policy And Practice ◽  
Public Health Emergencies ◽  
Key Points ◽  
Speed Up

Background:In public health emergencies, evidence, intervention, decisions and translation proceed simultaneously, in greatly compressed timeframes, with knowledge and advice constantly in flux. Idealised approaches to evidence-based policy and practice are ill equipped to deal with the uncertainties arising in evolving situations of need. Key points for discussion:There is much to learn from rapid assessment and outbreak science approaches. These emphasise methodological pluralism, adaptive knowledge generation, intervention pragmatism, and an understanding of health and intervention as situated in their practices of implementation. The unprecedented challenges of novel viral outbreaks like COVID-19 do not simply require us to speed up existing evidence-based approaches, but necessitate new ways of thinking about how a more emergent and adaptive evidence-making might be done. The COVID-19 pandemic requires us to appraise critically what constitutes ‘evidence-enough’ for iterative rapid decisions in-the-now. There are important lessons for how evidence and intervention co-emerge in social practices, and for how evidence-making and intervening proceeds through dialogue incorporating multiple forms of evidence and expertise. Conclusions and implications:Rather than treating adaptive evidence-making and decision making as a break from the routine, we argue that this should be a defining feature of an ‘evidence-making intervention’ approach to health.

scholarly journals Engaging Stakeholders to Retrospectively Discern Implementation Strategies in Support of Program Evaluation

2021 ◽  
Author(s):  
Jacob T. Painter ◽  
Rebecca A. Raciborski ◽  
Monica M. Matthieu ◽  
Ciara Oliver ◽  
David A. Adkins ◽  
...  
Keyword(s):  
Program Evaluation ◽  
Quality Improvement ◽  
Data Collection ◽  
Implementation Strategy ◽  
Implementation Strategies ◽  
Successful Implementation ◽  
Evidence Based ◽  
Main Body ◽  
Strategy Selection ◽  
Evidence Based Practices

Abstract Background: Successful implementation of evidence-based practices is key to healthcare quality improvement. However, it depends on appropriate selection of implementation strategies, the techniques that improve practice adoption or sustainment. When studying implementation of an evidence-based practice as part of a program evaluation, implementation scientists confront a challenge: the timing of strategy selection rarely aligns with the establishment of data collection protocols. Indeed, the exact implementation strategies used by an organization during a quality improvement initiative may be determined during implementation. Nevertheless, discernment of strategies is necessary to accurately estimate implementation effect and cost because this information can support decision making for sustainment, guide replication efforts, and inform the choice of implementation strategies for other evidence-based practices. Main body: We propose an iterative, stakeholder engaged process to discern implementation strategies when strategy choice was not made before data collection began. Stakeholders are centered in the process, providing a list of current and potential implementation activities. These activities are then mapped by an implementation science expert to an established taxonomy of implementation strategies. The mapping is then presented back to stakeholders for member checking and refinement. The final list can be used to survey those engaged in implementation activities in a language they are familiar with. A case study using this process is provided. Conclusion: It is challenging to estimate implementation effort when implementation strategy selection is disconnected from the data collection process. In these cases, a stakeholder-informed process to retrospectively identify implementation strategies by classifying activities performed using an established implementation strategy taxonomy provides the necessary information.

scholarly journals Seeing the quality improvement forest through the quality improvement trees: A meta-synthesis of case studies in Florida and Georgia

2019 ◽  
Vol 7 ◽  
pp. 205031211984570 ◽  
Author(s):  
William C Livingood ◽  
Lori Bilello ◽  
Katryne Lukens-Bull
Keyword(s):  
Public Health ◽  
Quality Improvement ◽  
Case Studies ◽  
Group Dynamics ◽  
Critical Role ◽  
Lessons Learned ◽  
Quality Improvement Intervention ◽  
Dissemination And Implementation ◽  
Evidence Based ◽  
Healthcare Settings

Objectives: To identify important characteristics of quality improvement applications for population health and healthcare settings and to explore the use of quality improvement as a model for implementing and disseminating evidence-based or best practices. Methods: A meta-synthesis was used to examine published quality improvement case studies. A total of 10 published studies that were conducted in Florida and Georgia were examined and synthesized using meta-synthesis (a qualitative research methodology) for meaningful insights and lessons learned using defined meta-synthesis inclusion criteria. The primary focus of the analysis and synthesis were the reported processes and findings that included responses to structured questioning in addition to emergent results from direct observation and semi-structured open-ended interviewing. Results: The key insights for the use of quality improvement in public health and healthcare settings included (1) the essential importance of data monitoring, analysis, and data-based decision making; (2) the need to focus on internal mutable factors within organizations; (3) the critical role of quality improvement team group dynamics; (4) the value of using a quality improvement collaborative or multi-clinic quality council/committee for sharing and comparing performance on key metrics; and (5) the need to identify a quality improvement approach and methods for clarification as a structured quality improvement intervention. Conclusion: In addition to the advantages of using quality improvement to enhance or improve healthcare and public health services, there is also potential for quality improvement to serve as a model for enhancing the adoption of evidence-based practices within the context of dissemination and implementation research.

scholarly journals Rugged landscapes: complexity and implementation science

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Joseph T. Ornstein ◽  
Ross A. Hammond ◽  
Margaret Padek ◽  
Stephanie Mazzucca ◽  
Ross C. Brownson
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Quality Improvement ◽  
Evolutionary Biology ◽  
Public Health Practice ◽  
Evidence Based ◽  
Health Practice ◽  
Context Specific ◽  
Evidence Based Programs ◽  
Evidence Based Decision Making

Abstract Background Mis-implementation—defined as failure to successfully implement and continue evidence-based programs—is widespread in public health practice. Yet the causes of this phenomenon are poorly understood. Methods We develop an agent-based computational model to explore how complexity hinders effective implementation. The model is adapted from the evolutionary biology literature and incorporates three distinct complexities faced in public health practice: dimensionality, ruggedness, and context-specificity. Agents in the model attempt to solve problems using one of three approaches—Plan-Do-Study-Act (PDSA), evidence-based interventions (EBIs), and evidence-based decision-making (EBDM). Results The model demonstrates that the most effective approach to implementation and quality improvement depends on the underlying nature of the problem. Rugged problems are best approached with a combination of PDSA and EBI. Context-specific problems are best approached with EBDM. Conclusions The model’s results emphasize the importance of adapting one’s approach to the characteristics of the problem at hand. Evidence-based decision-making (EBDM), which combines evidence from multiple independent sources with on-the-ground local knowledge, is a particularly potent strategy for implementation and quality improvement.

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