Table 2 Overview of implementation strategy for Agents of Change project, informed by Straus et al. [40]

 Gather information

• Literature review to establish known barriers and facilitators to implementation of evidence-based dementia care

• Implementation clinicians conduct local needs assessment and organisational mapping

• In-depth interviews with implementation clinicians and management

• Establish steering committee with representation from people with dementia and carers to guide project conduct

 Select strategies

• Implementation clinicians develop a formal implementation plan

• Implementation clinicians develop tailored strategies to overcome barriers

 Build buy-in

• Identify and prepare implementation clinicians

• Involve organisation managers who confirm the clinicians’ involvement in the project and commitment to support

• Involve members of the public (people with dementia and carers) and industry in all phases of the project

 Initiate leadership

• Implementation clinicians identified as ‘Agents of Change’ within their organisation

• Implementation clinicians establish ‘practice teams’ within their organisation to whom they will regularly report back and gather feedback

 Develop relationships

• Build the QICs

• Obtain formal research agreements

• Develop partnerships between the implementation clinicians, members of the public (people with dementia and carers), industry, expert clinicians, and research team

• One face-to-face start-up meeting

 Develop materials

• Development of MOOC with clinical content and focus on quality improvement in clinical settings

• MOOC developed in consultation with people with dementia and carers, industry experts, educational designer

• Development of implementation plan pro forma for clinicians

• Establish group norms and standards of collaboration

• Support for implementation clinicians to develop further site-specific resources

 Educate

• Provision of training through seven-module MOOC

• Phone orientation meeting with research team and face-to-face start up meeting to begin implementation plan brainstorming

• Implementation plan reviewed by a person with dementia and their carer, quality improvement expert, and clinical expert

• Support for implementation clinicians to gather feedback from ‘practice teams’ within their organisation

• Regular audit and feedback based on clinician self-report and client dyad-report

 Educate through peers

• Implementation plan reviewed by QIC peer

• Ongoing communications within the QIC via online forums and monthly videoconferencing

 Inform and influence stakeholders

• Use mass media, professional organisation newsletters, and industry publications to share information about the project and highlight implementation clinician plans

Restructure

• Implementation clinicians take a lead in quality improvement in their organisations

• Site-specific implementation plan may involve restructuring or changes in structure, equipment, or records

Quality management

• Iterative quality improvement process using PDSA cycles

• Ongoing peer supervision with subgroup of QIC members

• Support for implementation clinicians to gather ongoing feedback from ‘practice teams’ within their organisation

• Fidelity checking based on content of clinical interactions (via clinician self-report and patient and client dyad-report)

• Monthly QIC meetings in which each clinician will report their plan activity for the month

• Revisiting of implementation plan after each monthly meeting with update log; revised plan submitted 6 months after implementation

• Reminders

• Provision of client tools to increase uptake of best practice (to half of the sites)

• Ongoing access to people with dementia and carers and clinical, quality improvement experts throughout implementation and follow-up

 Incentive scheme

• Implementation clinicians who complete 18 months follow-up receive access up to $1000 stipend to present their work at a meeting or conference

• Provision of regular incentives to encourage fidelity (e.g. webinars and other resources, branded materials)