Getting to implementation: a protocol for a Hybrid III stepped wedge cluster randomized evaluation of using data-driven implementation strategies to improve cirrhosis care for Veterans.
Getting to implementation: a protocol for a Hybrid III stepped wedge cluster randomized evaluation of using data-driven implementation strategies to improve cirrhosis care for Veterans.
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DOI：
10.1186/s13012-020-01050-7
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发表时间：
2020-10-21
期刊：
影响因子：
--
通讯作者：
Chinman MJ
中科院分区：
文献类型：
--
作者：
Rogal SS;Yakovchenko V;Morgan T;Bajaj JS;Gonzalez R;Park A;Beste L;Miech EJ;Lamorte C;Neely B;Gibson S;Malone PS;Chartier M;Taddei T;Garcia-Tsao G;Powell BJ;Dominitz JA;Ross D;Chinman MJ
肝硬化是全球死亡率迅速上升的原因。为了改善肝硬化护理，退伍军人健康管理局（VHA）开发了肝脏创新团队（HIT）协作，以支持退伍军人医疗中心（VAMCs）提供循证肝硬化护理。这项随机HIT项目评估旨在开发和评估一种选择和应用实施策略以提高肝硬化护理质量的新方法。评估的目的是：(1)通过经验确定哪些实施策略组合与肝硬化退伍军人的循证实践（EBP）的成功实施相关，(2)将这些“数据驱动”的实施策略手工化，(3)评估数据驱动的实施策略在增加肝硬化EBP吸收方面的有效性。目标1将包括对所有VAMCs使用73种实施策略来改善肝硬化护理的在线调查，这些策略由实施变革分类的专家建议定义。将采用传统的统计方法和配置比较方法来确定哪些实施策略的组合与肝硬化患者对ebp的局部依从性有关。在目标2中，将对高绩效的VAMCs进行半结构化访谈，以实施肝硬化护理的成功实施策略。这些数据将用于编制一份逐步指南，指导如何调整和应用目标1中确定的执行战略。在目标3中，将使用混合III型楔形聚类随机设计对这种人工实施干预进行评估。该评估将在12个VAMCs中进行，其中4个VAMCs每6个月从对照过渡到干预，以评估使用数据驱动的实施策略来改善指南一致性肝硬化护理的有效性。这项创新评估的成功完成将确定利用早期评估数据为有机会改善护理的VAMCs提供手动、用户友好的实施干预措施的可行性。这一评价将提供实施支持工具，可用于加强其他循证实践的实施。该项目已在ClinicalTrials注册。Gov （NCT04178096）。
Cirrhosis is a rapidly increasing cause of global mortality. To improve cirrhosis care, the Veterans Health Administration (VHA) developed the Hepatic Innovation Team (HIT) Collaborative to support VA Medical Centers (VAMCs) to deliver evidence-based cirrhosis care. This randomized HIT program evaluation aims to develop and assess a novel approach for choosing and applying implementation strategies to improve the quality of cirrhosis care. Evaluation aims are to (1) empirically determine which combinations of implementation strategies are associated with successful implementation of evidence-based practices (EBPs) for Veterans with cirrhosis, (2) manualize these “data-driven” implementation strategies, and (3) assess the effectiveness of data-driven implementation strategies in increasing cirrhosis EBP uptake. Aim 1 will include an online survey of all VAMCs’ use of 73 implementations strategies to improve cirrhosis care, as defined by the Expert Recommendations for Implementing Change taxonomy. Traditional statistical as well as configurational comparative methods will both be employed to determine which combinations of implementation strategies are associated with site-level adherence to EBPs for cirrhosis. In aim 2, semi-structured interviews with high-performing VAMCs will be conducted to operationalize successful implementation strategies for cirrhosis care. These data will be used to inform the creation of a step-by-step guide to tailoring and applying the implementation strategies identified in aim 1. In aim 3, this manualized implementation intervention will be assessed using a hybrid type III stepped-wedge cluster randomized design. This evaluation will be conducted in 12 VAMCs, with four VAMCs crossing from control to intervention every 6 months, in order to assess the effectiveness of using data-driven implementation strategies to improve guideline-concordant cirrhosis care. Successful completion of this innovative evaluation will establish the feasibility of using early evaluation data to inform a manualized, user-friendly implementation intervention for VAMCs with opportunities to improve care. This evaluation will provide implementation support tools that can be applied to enhance the implementation of other evidence-based practices. This project was registered at ClinicalTrials.Gov (NCT04178096) on 4/29/20.
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影响因子：
12.7
作者：
Glasgow, RE;Vogt, TM;Boles, SM
通讯作者：
Boles, SM
DOI：
10.1007/s11121-017-0845-6
发表时间：
2018-05
期刊：
Prevention science : the official journal of the Society for Prevention Research
影响因子：
--
作者：
Chinman M;Acosta J;Ebener P;Malone PS;Slaughter ME
通讯作者：
Slaughter ME
影响因子：
3.1
作者：
Dunn, S. Hunter;Rogal, Shari S.;Beste, Lauren A.
通讯作者：
Beste, Lauren A.
定性比较分析：一种识别与程序有效性相关的因素的混合方法。
影响因子：
3.9
作者：
Cragun D;Pal T;Vadaparampil ST;Baldwin J;Hampel H;DeBate RD
通讯作者：
DeBate RD
影响因子：
9.8
作者：
Buchanan, Paula M.;Kramer, Jennifer R.;Kanwal, Fasiha
通讯作者：
Kanwal, Fasiha