Table 2 Examples of planned implementation strategies
CFIR Targets | Barrier | Implementation Strategy | Team member(s) responsible | Action | Qualitative Prompts for Aim 2 |
|---|---|---|---|---|---|
Inner setting, individuals involved | Physician champions are not aware of implementation plan | Identify and prepare champions | Research team, Carevive | Educate staff on rationale and details of the intervention | “What have you and your team done to build ‘buy in’ for your site’s remote symptom monitoring project?” |
Process of implementation | Technical issues may arise during implementation | Centralize technical assistance | Research team, Carevive | Provide technical support and conduct weekly team meetings to address challenges to implementation | “What has your team done to provide support and educate navigators and others to troubleshoot technical issues during implementation?” |
Intervention characteristics, individuals involved | Remote symptom monitoring are not utilized by navigators | Revise professional roles | Navigators | Assign responsibility for patient enrollment, monitoring, and responding to ePROs to navigator teams | “How did the additional role of remote symptom monitoring implementation impact the work of the navigators?” |
Intervention characteristics, individuals involved | Patients are unfamiliar with the technology | Change service site | Navigators | Assign patients to complete symptom ePROs at home | “How did changing the location of symptom collection from clinic only to home and clinic impact symptom management?” |
Intervention characteristics | ePRO data is unavailable for clinicians | Facilitate display of clinical data to providers | Carevive, Cerner | Use dashboard within EMR | “What was helpful within dashboard?” |
Process of implementation | The amount of data may be overwhelming for clinicians | Develop and organize quality monitoring and improvement | Research team, Carevive | Create reports to be used in weekly meetings | “How has your team responded to quality monitoring reports?” |
Inner setting, process of implementation | Patients may stop completing surveys; providers may stop alert response | Audit and feedback | Research team, Carevive | Create reports | “How did the feedback reports (or alerts) impact your ability to manage patient symptoms and implement remote symptom monitoring?” |
Process of implementation | There may be unexpected implementation challenges | Use implementation advisors | Dr. Stover, Dr. Howell, Dr. Weiner, research team | Calls with Dr. Stover | “How did the implementation advisor help the implementation?” |
All settings | Sites may have different applications of implementation strategies | Create a learning collaborative | Research team | Bi-monthly calls between implementation teams at UAB and MCI | “What were the benefits and challenges of participating in calls with your partner health system?” |
Process of implementation | There is an ongoing need for continuous system improvement | Plan for sustainability | Research team, Carevive, Blue Cross Blue Shield, administrators | Stakeholder engagement, technology improvements | “What were the key components you needed to be able to continue using remote symptom monitoring?” |