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Table 1 CARE intervention components during 6-month active phase

From: A facilitation model for implementing quality improvement practices to enhance outpatient substance use disorder treatment outcomes: a stepped-wedge randomized controlled trial study protocol

CARE component Rationale Execution Target
Training/tools on OUD medications, shared-decision making, and person-centered care Increase knowledge, skills, and, attitudes about evidenced-based practices to improve client outcomes 1-h, interactive web-based trainings; moderated discussion with external facilitator; guides/tools for OUD medication and shared decision making All clinic staff
Leadership engagement Gain buy-in from executive level of the organization to ensure resources available for QI processes and clinical practice change 1.5-h kick-off meeting with study team and ongoing updates and engagement from external facilitator and champions Clinic executive leadership
Establish clinic champion(s) and change team Structured team to conduct QI and change management activities Executive and clinic leadership select champion(s) with support from facilitator Identified clinic staff
Training on QI and change management Improve numeracy, data management, and quality improvement knowledge 45-min web-based training plus external facilitator provides training to champion; champion provide training to change team Clinic champion(s) and change team
Ongoing QI and change management activities Improve clinics’ ability to engage in data-driven, structured QI cycles and ongoing data monitoring Weekly 1-h change team meetings lead by clinic champions and supported by the external facilitator Clinic champion(s) and change team
eTPA8 client-reported treatment progress tool Improve clinical outcomes and capacity for technology-based data monitoring and QI Clients complete the eTPA8 every 2 weeks; staff monitor reports for use in clinical decision making; change team uses reports for QI All clinic staff, champions, change team