Implementation strategies Flashcards
(9 cards)
Implementation strategies
Active techniques to help people and organizations implement EBIs into practice and enhance the adoption, implementation and sustainment of research supported clinical interentions into practice
or
The HOW TO of implementation and
are the Heart of what we do in implementation strategies
ERIC and more than 73
Implementation strategies facts
- New strategies are developed ant tested regularly
- Evidence in trials of effectiveness of strategies but a lot to learn about why certain are effective
- Multifaceted, multilevel implementation strategies that complement one another to address implementation determinants, are most effective
They must accunt for the intervention, organization and people
Types of strategies
- Discrete: Single action or process (reminders) (handwash)
- Multifaceted: Combination of discrete (reminders + training) (handwash + campaign)
- Blended: Multifaceted that have been protocolized (branded innovation that facilitates) (handwash protocol)
Hand wash example
Necessary but not sufficient:
* Teaching knowledge
* Awareness campaigns
* Ensuring handwashing facilities
* cues to remind people
Additional
* Unit leadership
* social influence
* norms and targets
* training for self efficacy
9 categories of Implementation strategies
- Evaluative and iterative
- Interactive assistance
- adapt and tailor to context
- develop stakeholder relationships
- train educate stakeholders
- support clinicians
- engage consumers or patients
- financial strategies
- Change infraestructure
How to choose Implementation strategies?
ISLAGIATT: It seemed like a good idea at the time
Evaluate context:
* What are the barriers? (From CFIR) we need to overcome?
* What may help facilitate the implementation?
* How complex is the intervention?
* How many people or roles invovles?
* New or differnt from the intervention currently done?
* How many resources do you have?
* What can be done given a setting?
* How feasible?
Linking Theories / Frameworks to implementation strategies
Also clalled implementation mapping
- Theory or framework (CFIR)
- Barriers and facilitators: What does the hteory suggest may be barriers or facilitator related to the program?
- Implementation strategy (ERIC) what strategies can address barriers, how can you take advantage of facilitators?
CFIR/ERIC matching tool from article where articles chose 7 implementation strategies
Reporting implementaiton strategies
- They are poorly degined
- Lack detail about components
- Lack of rationale
- They must be defined conceptually and operationally so they can be reproducible (as EBIs)
so the process is
1. name stratey
2. define strategy
3. specify strategy
Specifying
- Actor: Who delivers the strategy
- Action: specific actions
- Action target: who we are targeting
- Temporality: timing when is used
- Dose: how much we are going to deliver
- Implementation outcome afffected: otucomes affected and measures of each strategy
- Justification, rationale: why of that choice
