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Table 4 Strategies significantly associated with treatment in both years vs. only Year 1 or Year 2

From: Longitudinal assessment of the association between implementation strategy use and the uptake of hepatitis C treatment: Year 2

Both years Year 1 only Year 2 only
Change infrastructure
• Change physical structure/equipment
• Change the location of clinical service sites
• Change accreditation or membership requirements
• Liability reform
• Change the record systems
Financial strategies
   • Alter incentive/allowance structures
Support clinicians
• Create new clinical teams
• Revise professional roles
• Develop resource sharing agreements • Facilitate the relay of clinical data to providers
Provide interactive assistance
• Provide clinical supervision • Local technical assistance
• Use a centralized system to deliver facilitation
Adapt and tailor to the context
   • Use data experts to manage HCV data
Train/educate providers
• Facilitate the formation of groups of providers and foster a collaborative learning environment • Conduct educational meetings
• Have an expert in HCV care meet with providers to educate them
• Provide ongoing HCV training
• Vary information delivery methods
• Use educational institutions to train clinicians
• Distribute educational materials
Develop stakeholder interrelationships
• Build a local coalition/team to address challenges
• Conduct local consensus discussions
• Recruit, designate, and/or train leaders
• Use modeling or simulated change
• Make efforts to identify early adopters to learn from their experiences
• Partner with a university
• Visit other sites outside your medical center to try to learn from their experiences
• Identify and prepare champions
• Inform local opinion leaders
• Share the knowledge gained from quality improvement efforts with other sites
• Build on existing high-quality working relationships and networks to promote information sharing and problem solving
• Organize support teams of clinicians who are caring for patients with HCV and given them time to share the lessons learned and support one another’s learning
• Involve executive boards
Use evaluative and iterative strategies
• Collect and summarize clinical performance data and give it to clinicians and administrators to implement changes in a cyclical fashion using small tests of change before making system-wide changes   • Assess for readiness and identify barriers and facilitators to change
• Develop a formal implementation blueprint
• Develop and organize systems that monitor clinical processes and/or outcomes for the purpose of quality assurance and improvement
• Intentionally examine the efforts to promote HCV care
• Conduct small tests of change, measured outcomes, and then refined these tests
• Develop strategies to obtain and use patient and family feedback
Engage consumers
  • Engage in efforts to prepare patients to be active participants in HCV care