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Table 3 Build QI capacity and improve outcomes. ERIC strategies included in EvidenceNOW interventions with Proctor specifications

From: Specifying and comparing implementation strategies across seven large implementation interventions: a practical application of theory

Expected outcomes: Improve ABCS outcomes and QI capacity Improved ABCS measures and increased practice capacity to take on new quality initiatives. Additional outcomes may vary by cooperative (e.g., joy in practice). Knowledge of evidence-based guidelines and QI techniques and principles is needed
Justification: practices are under-resourced for quality improvement and need external support to guide them through the change process. Implementation staff needs a supportive infrastructure to help them help practices achieve their goals
No. co-ops Name it Specify it
ERIC cluster ERIC strategy* Actor Specific action(s) Target
7 Provide interactive assistance Implementation facilitation PF Assist with the change process and support change efforts; review workflows and create actionable plans to put best practices in place (i.e., huddles, pre-visit planning, medication synchronization, gaps analysis, outreach, decision support use, patient education, etc.) Practice
7 Use evaluative and iterative strategies Assess for readiness and identify barriers and facilitators Data expert HIT-PF, PF Assess HIT needs and data set-up and workflow; assess clinic workflows; assess use of evidence-based protocols Practice
7 Use evaluative and iterative strategies Develop an implementation blueprint PF, HIT-PF Discuss and identify improvement plan; adjust plans according to data; develop actionable plans for implementation of evidence-based protocols and addressing other pain points (i.e. non-compliant patients) Practice
6 Use evaluative and iterative strategies Conduct cyclical small tests of change PF Develop and use Plan Do Study Act (PDSA), Define Measure Analyze Improve and Control (DMIAC), and other tests of change activities and processes involved in QI Practice
5 New Assess and redesign workflow PF Assess and revise clinic workflows using a variety of techniques (i.e., observations and mapping of workflow, role-redesign exercises) to facilitate discussion and implementation of evidence-based protocols Practice
4 Support clinicians Remind clinicians PF Assist the change process through use of clinical reminders and decision-support tools Practice
4 Develop stakeholder interrelationships Identify and prepare champions PF Assist in creating and engaging practice leaders and others in promoting efficient care strategies Practice
4 Develop stakeholder interrelationships Recruit, designate and train for leadership PF Assist in creating and facilitating practice leaders and others in promoting efficient care strategies Practice
4 Develop stakeholder interrelationships Organize implementation teams and team meetings PF Assist in creating and facilitating QI teams in promoting efficient care strategies Practice
4 Engage consumers Intervene with patients/consumers to enhance uptake and adherence PF Help generate patient lists for outreach from EHRs or registries; recall patients; offer patient education materials Practice
5 Develop stakeholder interrelations Use an implementation advisor Expert consultant PF-HIT Support and education for practice facilitators by data experts and/or physician faculty hired as expert consultants PF
  1. ABCS aspirin, blood pressure, cholesterol, and smoking cessation; PF practice facilitator; HIT health information technology; HIT-PF health information technology specialist practice facilitator; EHR electronic health record; data expert health informatics technology expert; expert consultant physician faculty or clinical expert; Q & A question and answer, FAQ frequently asked questions, extension agent community-based agent specializing in using community resources to address social determinants of health
  2. *modifications to ERIC labels and new strategies are in italics. Strategy definitions are in Table 1