Table 1 Elements of the Ask-Advise-Connect implementation strategy
Element | Description | Definition of strategy | |
|---|---|---|---|
First PTAM | During the first PTAMa (either on location or online), participants learned about the AAC method and made agreements about the implementation of the new method in practice (the agreements specified when, how and by whom AAC would be delivered in practice). Participants were also informed about different options for smoking cessation counselling and, if possible, introduced to a local counsellor outside the practice. The first PTAM was facilitated by a trained employee of the Dutch Institute for Rational Use of Medicine | Conduct educational meetings | “Hold meetings targeted toward different stakeholder groups to teach them about the clinical innovation.” |
Create a learning collaborative | “Facilitate the formation of groups of providers or provider organizations and foster a collaborative learning environment to improve implementation of the clinical innovation.” | ||
Engage community resources | “Connect practices and their patients to community resources outside the practice.” | ||
Desk card | During the first PTAM, participants received a desk card which describes the AAC method (see Fig. 1) | Remind clinician | “Develop reminder systems designed to help clinicians to recall information and/or prompt them to use the clinical innovation.” |
E-toolkit | After the first PTAM, participants received access to an online toolkit in which more information can be found about the AAC method | Distribute educational materials | “Distribute educational materials (including guidelines, manuals, and toolkits) in person, by mail, and/or electronically.” |
Second PTAM | Three months after the first PTAM, a second meeting was organized in which participants reflected on the previously made agreements and discussed best practices and possible solutions to encountered barriers. Aggregated data on Ask and Advise of T1-T3 versus T3-T6 was presented, except for in one PTAM group where not enough data was collected on Ask and Advise. The second PTAM was facilitated by one of the study researchers | Organize clinician implementation team meetings | “Develop and support teams of clinicians who are implementing the innovation and give them protected time to reflect on the implementation effort, share lessons learned, and support one another’s learning.” |
Audit and provide feedback | “Collect and summarize clinical performance data over a specified time period and give it to clinicians and administrators to monitor, evaluate, and modify provider behaviour.” | ||
Document ‘tips for barriers’ | After the second PTAM, participants received an online document with an overview of the most frequently mentioned barriers and tips on how to overcome these barriers | Distribute educational materials | “Distribute educational materials (including guidelines, manuals, and toolkits) in person, by mail, and/or electronically.” |