Elsevier

Mayo Clinic Proceedings

Volume 91, Issue 8, August 2016, Pages 1074-1083
Mayo Clinic Proceedings

Brief report
Reporting on the Strategies Needed to Implement Proven Interventions: An Example From a “Real-World” Cross-Setting Implementation Study

https://doi.org/10.1016/j.mayocp.2016.03.014Get rights and content
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open access

Abstract

The objective of this study was to empirically demonstrate the use of a new framework for describing the strategies used to implement quality improvement interventions and provide an example that others may follow. Implementation strategies are the specific approaches, methods, structures, and resources used to introduce and encourage uptake of a given intervention's components. Such strategies have not been regularly reported in descriptions of interventions' effectiveness, or in assessments of how proven interventions are implemented in new settings. This lack of reporting may hinder efforts to successfully translate effective interventions into “real-world” practice. A recently published framework was designed to standardize reporting on implementation strategies in the implementation science literature. We applied this framework to describe the strategies used to implement a single intervention in its original commercial care setting, and when implemented in community health centers from September 2010 through May 2015. Per this framework, the target (clinic staff) and outcome (prescribing rates) remained the same across settings; the actor, action, temporality, and dose were adapted to fit local context. The framework proved helpful in articulating which of the implementation strategies were kept constant and which were tailored to fit diverse settings, and simplified our reporting of their effects. Researchers should consider consistently reporting this information, which could be crucial to the success or failure of implementing proven interventions effectively across diverse care settings.

Trial Registration

clinicaltrials.gov Identifier: NCT02299791.

Abbreviations and Acronyms

ALL
a system-level QI intervention designed to increase the percentage of patients with diabetes appropriately prescribed cardioprotective medications— Aspirin, Lovastatin (any statin), and Lisinopril (any angiotensin-converting enzyme inhibitor/angiotensin receptor blocker)
CHC
community health center
KP
Kaiser Permanente
QI
quality improvement

Cited by (0)

Grant Support: Development of this manuscript, and the study which it describes, were supported by grant 1R18HL095481-01A1 from the National Heart, Lung, and Blood Institute (to all authors except D.J.C., E.K.P., and J.E.D.). D.J.C. was supported by grant CHF-3848 from the Colorado Health Foundation. J.E.D. was supported by grant CDRN-1306–04716 from the Patient Center Outcomes Research Institute. E.K.P. was supported by grant R25 MH080916 from the National Institute of Mental Health, grant UL1 RR024992 from the National Center for Research Resources, grant U54 CA155496 from the National Cancer Institute, and grant P30 DK092950 from the National Heart, Lung, and Blood Institute. The funding bodies had no further role in the concept development or writing of this article, or the decision to submit it for publication.