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Table 3 Project Specific Detail

From: Experiences of using the i-PARIHS framework: a co-designed case study of four multi-site implementation projects

Research TeamMental 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.
FundingThis 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.
MethodCombined 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 approachWhat 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 MeasuresTeam 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.
Scale9 sites.8 wards (4 control and 4 intervention wards) across 4 sites.6 sites.11 acute public and private Australian hospitals.
Implementation Duration12 months per site.18 months.6 months.4–12 months.