Table 1 Implementation Strategy Components used in the PREDICT Bronchiolitis KT Study [4, 33]

Clinical leads

Four clinical leads for the duration of the study, included a medical and a nursing lead from each emergency department and inpatient paediatric areas.

Key tasks included attending a 1-day train-the-trainer workshop, spearheading educational intervention and other educational materials delivery to all staff, supervising monthly audit completion and delivery of feedback, and management of study requirements.

Encouraged to allocate a medical and nursing lead, but no further guidance provided.

Stakeholder Meetings

Study team presented the Australasian Bronchiolitis Guideline to clinical leads, discussed local and international bronchiolitis management variations, reviewed results of the local audit, and discussed any local anticipated barriers, with the aim to gain site buy-in.

Nil.

Train-the- trainer workshop

1-day workshop for clinical leads: discussed Australasian Bronchiolitis Guideline and evidence supporting recommendations, qualitative study identifying the facilitators and barriers of bronchiolitis management, implementation, and the development of interventions. Clinical leads received demonstrations on how to deliver educational interventions to their staff, outlines of study data timelines and requirements, and enabled planning time for clinical leads.

One-day workshop providing bronchiolitis intervention materials, with up to four clinical leads (medical and nursing) invited to attend. Discussion on what the aims of education materials were. Individual hospital data from the cluster RCT was presented (2014-2017). Feedback in relation to similar hospitals.

Educational intervention delivery

Key findings from qualitative study were presented in a PowerPoint with scripted messages stating use of behaviour change techniques most likely to effect change.

Clinical Leads oversaw education delivery to medical and nursing staff using PowerPoint presentation.

Within first month, aimed to educate 80% of staff and to ensure all staff educated ongoing education provided throughout duration of study.

PowerPoint presentation which was the same as presentation provided to the intervention hospitals.

Use of other educational materials

Clinical leads locally delivered promotional materials, evidence factsheets, clinician training video, and parent/caregiver information.

Education materials that were provided to the intervention hospitals.

Audit and feedback

Monthly audits of the first 20 bronchiolitis presentations, with report providing comparison between individual hospital results and top-performing site. Clinical leads disseminated report to their staff in written and verbal format; action planning with target setting encouraged.

Audit form and own hospital results from trial (4 years of data).

Ongoing facilitation

Weekly contact between clinical leads and study leads. Opportunities to ask questions via email.

Nil.