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

Byron J Powell, Thomas J Waltz, Matthew J Chinman, Laura J Damschroder, Jeffrey L Smith, Monica M Matthieu, Enola K Proctor, JoAnn E Kirchner, Byron J Powell, Thomas J Waltz, Matthew J Chinman, Laura J Damschroder, Jeffrey L Smith, Monica M Matthieu, Enola K Proctor, JoAnn E Kirchner

Abstract

Background: Identifying, developing, and testing implementation strategies are important goals of implementation science. However, these efforts have been complicated by the use of inconsistent language and inadequate descriptions of implementation strategies in the literature. The Expert Recommendations for Implementing Change (ERIC) study aimed to refine a published compilation of implementation strategy terms and definitions by systematically gathering input from a wide range of stakeholders with expertise in implementation science and clinical practice.

Methods: Purposive sampling was used to recruit a panel of experts in implementation and clinical practice who engaged in three rounds of a modified Delphi process to generate consensus on implementation strategies and definitions. The first and second rounds involved Web-based surveys soliciting comments on implementation strategy terms and definitions. After each round, iterative refinements were made based upon participant feedback. The third round involved a live polling and consensus process via a Web-based platform and conference call.

Results: Participants identified substantial concerns with 31% of the terms and/or definitions and suggested five additional strategies. Seventy-five percent of definitions from the originally published compilation of strategies were retained after voting. Ultimately, the expert panel reached consensus on a final compilation of 73 implementation strategies.

Conclusions: This research advances the field by improving the conceptual clarity, relevance, and comprehensiveness of implementation strategies that can be used in isolation or combination in implementation research and practice. Future phases of ERIC will focus on developing conceptually distinct categories of strategies as well as ratings for each strategy's importance and feasibility. Next, the expert panel will recommend multifaceted strategies for hypothetical yet real-world scenarios that vary by sites' endorsement of evidence-based programs and practices and the strength of contextual supports that surround the effort.

Figures

Figure 1
Figure 1
Overview of the voting process in the final round of the modified Delphi task. In the third and final round of the modified Delphi task, expert panelists will vote on all strategies where concerns were raised regarding the core definition in the first two online survey rounds. For each strategy, the original and proposed alternate definitions will be presented for an approval poll where participants can vote to approve all definition alternatives they find acceptable. In the first round of voting, if one definition receives a supermajority of votes (≥60%) and receives more votes than all others, that definition will be declared the winner and the poll will move to the next term. If there is no consensus, a 5-min discussion period is opened. When the discussion concludes, a runoff poll is conducted to determine the most acceptable definition alternative [13].

References

    1. Proctor EK, Powell BJ, McMillen JC. Implementation strategies: recommendations for specifying and reporting. Implement Sci. 2013;8:1–11. doi: 10.1186/1748-5908-8-1.
    1. Institute of Medicine . Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy Press; 2001.
    1. Institute of Medicine . Improving the quality of health care for mental and substance-use conditions. Washington, DC: National Academy Press; 2006.
    1. Institute of Medicine . Initial national priorities for comparative effectiveness research. Washington, DC: The National Academies Press; 2009.
    1. Eccles MP, Armstrong D, Baker R, Cleary K, Davies H, Davies S, et al. An implementation research agenda. Implement Sci. 2009;4:1–7. doi: 10.1186/1748-5908-4-1.
    1. Michie S, Fixsen DL, Grimshaw JM, Eccles MP. Specifying and reporting complex behaviour change interventions: the need for a scientific method. Implement Sci. 2009;4:1–6. doi: 10.1186/1748-5908-4-40.
    1. McKibbon KA, Lokker C, Wilczynski NL, Ciliska D, Dobbins M, Davis DA, et al. A cross-sectional study of the number and frequency of terms used to refer to knowledge translation in a body of health literature in 2006: a tower of Babel? Implement Sci. 2010;5:1–11. doi: 10.1186/1748-5908-5-16.
    1. Colquhoun H, Leeman J, Michie S, Lokker C, Bragge P, Hempel S, et al. Towards a common terminology: a simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies. Implement Sci. 2014;9:1–6. doi: 10.1186/1748-5908-9-1.
    1. Waltz TJ, Powell BJ, Chinman MJ, Smith JL, Matthieu MM, Proctor EK, et al. Expert Recommendations for Implementing Change (ERIC): protocol for a mixed methods study. Implement Sci. 2014;9:1–12. doi: 10.1186/1748-5908-9-39.
    1. Powell BJ, McMillen JC, Proctor EK, Carpenter CR, Griffey RT, Bunger AC, et al. A compilation of strategies for implementing clinical innovations in health and mental health. Med Care Res Rev. 2012;69:123–57. doi: 10.1177/1077558711430690.
    1. Gerring J. Social science methodology: a criterial framework. Cambridge: Cambridge University Press; 2001.
    1. Rabin BA, Brownson RC. Developing terminology for dissemination and implementation research. In: Brownson RC, Colditz GA, Proctor EK, editors. Dissemination and implementation research in health: translating science to practice. New York: Oxford University Press; 2012. pp. 23–51.
    1. Albrecht L, Archibald M, Arseneau D, Scott SD. Development of a checklist to assess the quality of reporting of knowledge translation interventions using the Workgroup for Intervention Development and Evaluation Research (WIDER) recommendations. Implement Sci. 2013;8:1–5. doi: 10.1186/1748-5908-8-52.
    1. Davidoff F, Batalden P, Stevens D, Ogrinc G, Mooney S. Publication guidelines for quality improvement in health care: evolution of the SQUIRE project. Qual Saf Health Care. 2008;17(Supplement 1):i3–9. doi: 10.1136/qshc.2008.029066.
    1. Cochrane Effective Practice and Organisation of Care Group . Data collection checklist. 2002. pp. 1–30.
    1. Leeman J, Baernholdt M, Sandelowski M. Developing a theory-based taxonomy of methods for implementing change in practice. J Adv Nurs. 2007;58:191–200. doi: 10.1111/j.1365-2648.2006.04207.x.
    1. Walter I, Nutley S, Davies H. Developing a taxonomy of interventions used to increase the impact of research. Andrews: University of St. Andrews of St. Andrews; 2003.
    1. Mazza D, Bairstow P, Buchan H, Chakraborty SP, Van Hecke O, Grech C, et al. Refining a taxonomy for guideline implementation: results of an exercise in abstract classification. Implement Sci. 2013;8:1–10. doi: 10.1186/1748-5908-8-32.
    1. Bero LA, Grilli R, Grimshaw JM, Harvey E, Oxman AD, Thomson MA. Getting research findings into practice: closing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings. Br Med J. 1998;317:465–8. doi: 10.1136/bmj.317.7156.465.
    1. Grimshaw JM, Eccles M, Thomas R, MacLennan G, Ramsay C, Fraser C, et al. Toward evidence-based quality improvement. Evidence (and its limitations) of the effectiveness of guideline dissemination and implementation strategies 1966–1998. J Gen Intern Med. 2006;21(Suppl 2):S14–20.
    1. Grol R, Grimshaw JM. From best evidence to best practice: effective implementation of change in patients’ care. Lancet. 2003;362:1225–30. doi: 10.1016/S0140-6736(03)14546-1.
    1. Shojania KG, Ranji SR, McDonald KM, Grimshaw JM, Sundaram V, Rushakoff RJ, et al. Effects of quality improvement strategies for type 2 diabetes on glycemic control: a meta-regression analysis. JAMA. 2006;296:427–40. doi: 10.1001/jama.296.4.427.
    1. Cabana MD, Rushton JL, Rush J. Implementing practice guidelines for depression: applying a new framework to an old problem. Gen Hosp Psychiatry. 2002;24:35–42. doi: 10.1016/S0163-8343(01)00169-4.
    1. Gilbody S, Whitty P, Grimshaw JM, Thomas R. Educational and organizational interventions to improve the management of depression in primary care: a systematic review. JAMA. 2003;289:3145–51. doi: 10.1001/jama.289.23.3145.
    1. Stone EG, Morton SC, Hulscher ME, Maglione MA, Roth EA, Grimshaw JM, et al. Interventions that increase use of adult immunization and cancer screening services: a meta-analysis. Ann Intern Med. 2002;136:641–51. doi: 10.7326/0003-4819-136-9-200205070-00006.
    1. Hysong SJ, Best RG, Pugh JA. Clinical practice guideline implementation strategy patterns in veterans affairs primary care clinics. Health Serv Res. 2007;42:84–103. doi: 10.1111/j.1475-6773.2006.00610.x.
    1. Magnabosco JL. Innovations in mental health services implementation: a report on state-level data from the U.S. evidence-based practices project. Implement Sci. 2006;1:1–11. doi: 10.1186/1748-5908-1-13.
    1. Katon WJ, Zatzick D, Bond G, Williams J. Dissemination of evidence-based mental health interventions: importance to the trauma field. J Trauma Stress. 2006;19:611–23. doi: 10.1002/jts.20147.
    1. McHugh RK, Barlow DH. The dissemination and implementation of evidence-based psychological treatments. Am Psychol. 2010;65:73–84. doi: 10.1037/a0018121.
    1. Ryan R, Lowe D, Santesso N, Hill S. Development of a taxonomy of interventions directed at consumers to promote evidence-based prescribing and medicines use: a tool for evidence-based decision-making. Melbourne, Australia: In National Medicines Symposium; 2010.
    1. Raghavan R, Bright CL, Shadoin AL. Toward a policy ecology of implementation of evidence-based practices in public mental health settings. Implement Sci. 2008;3:1–9. doi: 10.1186/1748-5908-3-26.
    1. Mathew D, McKibbon KA, Lokker C, Colquhoun H. Engaging with a wiki related to knowledge translation: a survey of WhatisKT Wiki user. J Med Internet Res. 2014;16:e21. doi: 10.2196/jmir.3001.
    1. Palinkas LA, Horwitz SM, Green CA, Wisdom JP, Duan N, Hoagwood K. Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Adm Policy Ment Health. 2013
    1. Stetler CB, Mittman BS, Francis J. Overview of the VA Quality Enhancement Research Initiative (QUERI) and QUERI theme articles: QUERI series. Implement Sci. 2008;3:1–9. doi: 10.1186/1748-5908-3-1.
    1. Proctor EK, Landsverk J, Baumann AA, Mittman BS, Aarons GA, Brownson RC, et al. The implementation research institute: training mental health implementation researchers in the United States. Implement Sci. 2013;8:1–12. doi: 10.1186/1748-5908-8-1.
    1. Hasson F, Keeney S. Enhancing rigor in the Delphi technique research. Technol Forecast Soc Change. 2011;78:1695–704. doi: 10.1016/j.techfore.2011.04.005.
    1. Fishburn PC, Brams SJ. Expected utility and approval voting. Syst Res Behav Sci. 1981;26:136–42. doi: 10.1002/bs.3830260206.
    1. Brams SJ, Fishburn PC. Approval voting. Am Polit Sci Rev. 1978;72:831–47. doi: 10.2307/1955105.
    1. Oleszek WJ. Super-majority votes in the Senate. Washington, D.C.: Congressional Research Service; 2008. pp. 1–3.
    1. WIDER recommendations to improve reporting of the content of behaviour change interventions []
    1. Davidoff F, Batalden P. Toward stronger evidence on quality improvement. Draft publication guidelines: the beginning of a consensus project. Qual Saf Health Care. 2005;14:319–25. doi: 10.1136/qshc.2005.014787.
    1. Proctor EK, Rosen A. From knowledge production to implementation: research challenges and imperatives. Res Soc Work Pract. 2008;18:285–91. doi: 10.1177/1049731507302263.
    1. Kane M, Trochim WMK. Concept mapping for planning and evaluation. Thousand Oaks, CA: Sage; 2007.
    1. Ivers NM, Sales A, Colquhoun H, Michie S, Foy R, Francis JJ, et al. No more “business as usual” with audit and feedback interventions: towards an agenda for a reinvigorated intervention. Implement Sci. 2014;9:1–8. doi: 10.1186/1748-5908-9-14.
    1. Nadeem E, Olin S, Hoagwood KE, Horwitz SM. Understanding the components of quality improvement collaboratives: a systematic literature review. Milbank Q. 2013;91:354–94. doi: 10.1111/milq.12016.
    1. Dorsey S, Pullman MD, Deblinger E, Berliner L, Kerns SE, Thompson K, et al. Improving practice in community-based settings: a randomized trial of supervision—study protocol. Implement Sci. 2013;8:1–11. doi: 10.1186/1748-5908-8-89.
    1. Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:1–15. doi: 10.1186/1748-5908-4-50.
    1. Michie S, Johnston M, Abraham C, Lawton R, Parker D, Walker A. Making psychological theory useful for implementing evidence based practice: a consensus approach. Qual Saf Health Care. 2005;14:26–33. doi: 10.1136/qshc.2004.011155.
    1. Cane J, O’Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci. 2012;7:1–17. doi: 10.1186/1748-5908-7-37.
    1. Rycroft-Malone J. The PARiHS framework: a framework for guiding the implementation of evidence-based practice. J Nurs Care Qual. 2004;19:297–304. doi: 10.1097/00001786-200410000-00002.
    1. Wensing M, Grimshaw JM, Eccles MP. Does the world need a scientific society for research on how to improve healthcare? Implement Sci. 2012;7:1–4. doi: 10.1186/1748-5908-7-1.
    1. Shojania KG, McDonald KM, Wachter RM, Owens DK. Closing the quality gap: a critical analysis of quality improvement strategies, volume 1—series overview and methodology. Technical review 9. Agency for Healthcare Research and Quality: Rockville, MD; 2004.
    1. Wensing M, Bosch M, Grol R. Selecting, tailoring, and implementing knowledge translation interventions. In: Straus S, Tetroe J, Graham ID, editors. Knowledge translation in health care: moving from evidence to practice. Oxford, UK: Wiley-Blackwell; 2009. pp. 94–113.

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