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Table 1 SPREAD-NET implementation components

From: Study protocol for “Study of Practices Enabling Implementation and Adaptation in the Safety Net (SPREAD-NET)”: a pragmatic trial comparing implementation strategies

Implementation support strategy Description Study arm 1 Study arm 2 Study arm 3
CVD risk management bundle implementation toolkit • Overview of OCHIN’s DM/CVD QI bundle X X X
• Staff training/patient education materials
• Documents to support ALL implementation: underlying evidence
• How to use bundle tools in workflows
• Additional tools: posters, patient handouts, after-visit summary text
• Webinar on how to use the toolkit
• How to train your clinic staff to use the bundle
• How to implement practice changes, e.g., Plan-Do-Study-Act (PDSA) cycles [110118]
• Annual webinars with updates
• Relevant references and links
In-person training, quarterly follow-up webinars • 2-day training in Portland, Oregon: how to use the bundle, and how to train others to use it   X X
• Hands-on training in how to use bundle tools (e.g. panel management)
• Focus on building skills around change management techniques (e.g., PDSA cycles)
• Quarterly webinars; topics chosen by clinics to enhance implementation skills
On-site practice facilitation • Up to 5 visits per clinic, including:    X
Staff presentations
Coaching on presenting the tools to clinic staff, and using the tools in clinic workflows
Tailored problem-solving support to address barriers
Clinical questions fielded by practice facilitator
• Ongoing telephone/e-mail support as needed