Developing a targeted, theory-informed implementation intervention using two theoretical frameworks to address health professional and organisational factors: a case study to improve the management of mild traumatic brain injury in the emergency department

Tavender, Emma J.; Bosch, Marije; Gruen, Russell L.; Green, Sally E.; Michie, Susan; Brennan, Sue E.; Francis, Jill J.; Ponsford, Jennie L.; Knott, Jonathan C.; Meares, Sue; Smyth, Tracy; O’Connor, Denise A.

doi:10.1186/s13012-015-0264-7

Implementation Science

Table 7 Operationalisation of intervention components

From: Developing a targeted, theory-informed implementation intervention using two theoretical frameworks to address health professional and organisational factors: a case study to improve the management of mild traumatic brain injury in the emergency department

	Stakeholder meeting	Local opinion leader	Train the trainer	Local training workshops	Tools and materials to prompt recommended behaviours
Rationale for intervention component	Findings from interviews: Organisational and TDF factors	Findings from interviews: Organisational factors Cochrane EPOC reviews	Findings from interviews: Organisational and TDF factors Cochrane EPOC reviews feasibility information	Findings from interviews: Organisational and TDF factors Cochrane EPOC reviews feasibility information	Findings from interviews: Organisational and TDF factors Cochrane EPOC reviews feasibility information
Intervention content	Provide an opportunity to create buy-in at an organisational level and for senior leadership to express support. Provide opportunity to start conversation with stakeholders within hospital (outside ED) Key recommended behaviours and supporting evidence	Recruitment of local opinion leaders (one senior nurse and one medical lead from each participating hospital) to lead the project and train staff	Training and education including information/education on the key recommended practices and consequences of performing and not performing the behaviours, persuasive messages, skill development, modelling/demonstration and planning/implementation	Information/education on the key recommended practices and consequences of performing and not performing the behaviours, persuasive messages, skill development, modelling/demonstration	PTA assessment tool. Evidence-based discharge information sheet in different languages CT clinical decision tools lanyards. Checklist reminder stickers for patient records
Intervention content	Endorsement letters from relevant ED colleges. Practicalities of how these will be implemented including discussion of local pathways and protocols and how to overcome anticipated barriers to implementation		Leadership and change management training (e.g. information on the importance and content of the role of the clinical leads)		Posters providing information on the evidence-based approach to managing patients with mTBI
Characteristics of those delivering the intervention	Senior research team clinicians	Not applicable	Senior research team clinicians	Local opinion leaders (nurse and medical)	Research team
Characteristics of those delivering the intervention	Senior research team clinicians	Not applicable	Clinical opinion leaders	Local opinion leaders (nurse and medical)	Research team
Characteristics of the recipient(s)	Local stakeholders (both clinical as well as change management, e.g. ED Director, nominated local opinion leaders and other stakeholders such as occupational therapists or radiologists)	Not applicable	Local opinion leaders—one senior nurse and one medical lead from each participating hospital	Staff in the Emergency Department responsible for the management of mTBI patients.	Local opinion leaders and staff in the Emergency Department responsible for the management of mTBI patients.
Setting	Participating hospitals	Participating hospitals	Off-site conference venue	Participating hospitals	Participating hospitals
Relevant BCTs for PTA behaviour	Information regarding behaviour, outcome.	Not applicable	Information regarding behaviour, outcome	Information regarding behaviour, outcome	Environmental changes
	Health consequences		Antecedents	Antecedents	Information regarding behaviour, outcome
	Persuasive communication		Health consequences	Health consequences
	Social processes of encouragement, pressure, support		Goal/target specified behaviour or outcome	Graded task, starting with easy tasks
			Graded task, starting with easy tasks	Increasing skills: problem solving, decision making, goal setting
			Increasing skills: problem solving, decision making, goal setting	Modelling/demonstration of behaviour of others
			Rehearsal of relevant skills	Persuasive communication
			Modelling/demonstration of behaviour of others	Social processes of encouragement, pressure, support
			Persuasive communication	Pros and Cons
			Social processes of encouragement, pressure, support	Vicarious reinforcement
			Pros and Cons	Social and environmental consequences
			Vicarious reinforcement	Salience of consequences
			Social and environmental consequences
			Salience of consequences
			Focus on past success
Mode of delivery	Face-to-face meeting	One medical and nursing lead	Mixed, interactive and didactic workshop	Face to face workshops (mixed or clinician group specific depending on current training infrastructure in participating hospitals)	Printed copies
				Online presentations available for those not able to attend workshops	Online versions
					CT decision rules provided as lanyards
Intensity or dose	One meeting	Part-time	Two events in different Australian states	1 brief presentation per clinical topic, 1 demonstration session	For use with every patient
Intensity or dose	One meeting	Part-time	Two events in different Australian states	Number of repeats left to LOLs	For use with every patient
Duration	One hour in length	Duration of the project	Full day	10–20 min per session	Not applicable

Back to article page

ISSN: 1748-5908

Contact us

Submission enquiries: Access here and click Contact Us
General enquiries: info@biomedcentral.com