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Table 5 Blueprint for sustainment

From: A methodology for generating a tailored implementation blueprint: an exemplar from a youth residential setting

Importance Goal Responsible Feasibility Impact Implementation category Action step
H 1, 2, 3 IT H 3 Develop stakeholder interrelationships Engage implementation team
H 1, 3 IT L 2 Develop stakeholder interrelationships Hold cross-staff clinical meetings
H 3 IT L 3 Use evaluative and iterative strategies Develop and implement for quality monitoring––must monitor fidelity through observation regularly and randomly
H 1, 3 IT H 1 Train and educate stakeholders Conduct educational meetings––hold regularly for new staff and as refreshers
H 1, 3 IT L 3 Train and educate stakeholders Use train-the-trainer strategies––only those certified in CBT
H 1, 2, 3 IT L 2 Provide interactive assistance Centralize technical assistance––create standard operating procedure for training and use of CBT at each staff level
L 1, 2 IT L 2 Utilize financial strategies Alter incentives––provide raise earlier based on competency
L 1, 3 IT L 2 Use evaluative and iterative strategies Obtain and use consumer feedback w/PQI data collection
L 1, 3 IT L 2 Train and educate stakeholders Shadow other experts––elongate period for new staff
L 1, 2, 3 IT L 2 Train and educate stakeholders Develop learning collaborative
L 3 B/IT L 2 Use evaluative and iterative strategies Stage implementation scale-up to generate plan across site
L 3 B/IT L 2 Engage consumers Use mass media––get press release out with data from implementation
  1. “Importance” contains “H” for “High” (i.e., strategy must be enacted because it targets a highly important barrier), “M” for “Moderate” (i.e., the strategy should be prioritized if resources are available), or a “L” for “Low” (i.e., strategy should only be enacted if time and resources are available). “Goal” contains a 1, 2, or 3 to indicate which of the top 3 goals the strategy would primarily target. “Responsible” reflects whether the strategy should be enacted by the “IT” (i.e., Implementation Team at Wolverine Human Services) or “B” (i.e., Beck Institute or other external experts). “Feasibility” contains either “H” for “High” or “L” for “Low” in terms of the ease with which a given strategy could be enacted. “Impact” contains a score from 1 to 3 to reflect the degree to which the strategy would likely impact the fidelity with which CBT would be delivered. “Implementation Category” is derived from an expert-engaged concept mapping exercise in which nine conceptually distinct categories emerged: Adapt and Tailor to the Context, Change Infrastructure, Develop Stakeholder Interrelationships, Engage Consumers, Provide Interactive Assistance, Support Clinicians, Train and Educate Stakeholders, Utilize Financial Strategies, Use Evaluative and Iterative Strategies. Implementation Strategy contains the name of the strategy to be enacted. Timeline: Monitor 1 year post formal training
  2. Note. Goals: 1 train new staff efficiently; 2 maintain climate and communication; 3 sustain integration and penetration of CBT