|1 BHIP||2 CHERISH||3 SIMPLE||4 REACH|
|Research Team||Mental health services researchers and implementation scientists from the VA Behavioural Health Quality Enhancement Research Initiative (QUERI) Program.||A collaborative national team of clinical and academic researchers with an international advisor. This team included geriatric content experts, effectiveness evaluation experts, and implementation experts.||A collaborative state-wide team of clinicians and clinical and academic researchers with an international advisor.||A collaborative national team of researchers. This team included implementation science experts, infection control nursing experts, epidemiology experts, psychology experts, medical microbiology experts, and economics and statistics experts.|
|Funding||This project was funded as a part of the VA Behavioural Health QUERI Program (Grant # QUE 15–289), which was competitively funded from 2015 to 2020.||This project was funded by a Queensland Accelerate Partnership Grant (co-funded by Queensland Government, Queensland University of Technology and participating health services) from 2015 to 2017.||This project was funded for implementation by the Allied Health Professions Office of Queensland; evaluation was funded through an Australian Centre for Health Services Innovation (AusHSI) Implementation Grant.||This project was funded by a National Health and Medical Research Council (NHMRC) Partnership Project.|
|Study aims||(i) To assess whether the evidence-based CCMs can be successfully implemented using existing staff in general mental health clinics supported by internal and external implementation facilitation|
(ii) To evaluate the impact of CCM implementation efforts on patient health status and perceptions of care
|(i) To evaluate the effectiveness and cost-effectiveness of the Eat Walk Engage program for inpatients aged 65 years and older.|
(ii) A process evaluation to understand how and where the program worked.
|(i) To implement SIMPLE in six pilot hospitals across Queensland, purposively sampled to ensure diverse service models and case mix.|
(ii) To evaluate whether SIMPLE delivered more appropriate nutrition care to more patients at a lower cost per patient.
|(i) Evaluate the effectiveness of an environmental cleaning bundle to reduce hospital acquired infections in Australian hospitals|
(ii) Estimate the cost-effectiveness of a decision to adopt the environmental cleaning bundle for Australian hospitals.
|Method||Combined research and quality improvement project.|
This project utilised a randomised stepped-wedge implementation trial – Hybrid II design: Concurrent measurement of intervention effectiveness and implementation effectiveness.
|Cluster randomised controlled trial - Hybrid I design: Primary measurement of intervention effectiveness, cost-effectiveness with pre-planned measurement of implementation effectiveness.||Pre-post audits of nutrition care practices and dietetics occasions of service was used to evaluate the implementation of SIMPLE.||Randomised control trial using a cross-sectional stepped-wedge randomised allocation.|
|Implementation approach||What did they do: Internal-external model of facilitation.|
Who did it: A study-funded external facilitator with a site-funded local internal facilitator.
|What did they do: Internal-external model of facilitation.|
Who did it: Study-funded external facilitators and locally recruited clinical internal facilitators at each site. Partnership funding meant that the health service indirectly funded their novice facilitators
|What did they do: Internal-external model of facilitation, with Consolidated Framework for Implementation Research (Damschroder et al., 2009) used to describe the baseline context at each site (using interviews with key informants)|
Who did it: Study-funded external/experienced facilitators across the sites and study-funded locally recruited clinical internal/novice facilitators at each site.
|What did they do: External model of facilitation with local champions.|
Who did it: The research team assessed local context and provided support across the sites with local change champions in each site.
|Evaluation Measures||Team functioning, team processes, provider interviews for care experiences reflecting CCM [implementation outcomes]; patient surveys for health status and perceptions of care (at three time points), mental health hospitalization rate [intervention outcomes].||Ward process measures, patient interviews, evaluation of context, recipients, facilitation process and multi-disciplinary team engagement.||Nutrition care practices (documented and patient-reported), dietetic and allied health assistant occasions of service, evaluation of context, and facilitation process.||Pre and post questionnaire to measure knowledge and attitudes in staff, changes in practice (pre-post bundle alignment) to assess intervention fidelity, improvements in cleaning performance as assessed through routine collection of gel dot audits.|
|Scale||9 sites.||8 wards (4 control and 4 intervention wards) across 4 sites.||6 sites.||11 acute public and private Australian hospitals.|
|Implementation Duration||12 months per site.||18 months.||6 months.||4–12 months.|