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Table 2 Implementation strategies operationalised across three study arms

From: OASI2: a cluster randomised hybrid evaluation of strategies for sustainable implementation of the Obstetric Anal Sphincter Injury Care Bundle in maternity units in Great Britain

Study timeline Operationalised strategy in OASI2 Relevant ERIC strategies Study arm
Lean Peer support Sustain-ability
Set-up Heads of midwifery/clinical directors select one obstetrician and one midwife to take on the OASI QI Lead role (informed by a role description) Identify and prepare champions; facilitation; clinical supervision X X X
OASI QI Leads get 1 day/month of protected time to dedicate to OASI-CB sustainability in own unit and to support buddy unit Fund & contract for the clinical innovation    X
Launch OASI QI Leads prepared for external facilitator (‘buddy’) role during virtual skills development days organised by clinical and implementation experts (Project Team) Recruit, designate and train for leadership    X
OASI QI Leads receive the Implementation Toolkit Develop an implementation blueprint; use educational materials X X X
OASI QI Leads paired up with and introduced to their ‘buddies’ Create a learning collaborative   X  
Throughout the study period OASI QI Leads engage with their ‘buddies’ on a monthly basis (minimum) to seek implementation guidance Provide local technical assistance; shadow other experts   X  
OASI QI Leads to receive centralised support from clinical and implementation experts (Project Team) via monthly advisory meetings Centralise technical assistance; use an implementation advisor; provide ongoing consultation; promote network weaving; organize clinician implementation team meetings    X
Monthly contact between Project Team and heads of midwifery/ clinical directors to encourage senior buy-in from key members of staff within unit i.e. Labour ward lead, Band 7 labour ward co-ordinators, Patient Safety Leads, QI team etc. and to introduce the OASI-CB into local guidelines and mandatory training / induction packages for new staff (obstetricians and midwives) Involve executive boards; mandate change/ create or change credentialing and/or licensure standards    X
  1. OASI obstetric anal sphincter injury, QI quality improvement, OASI-CB OASI Care Bundle, ERIC Expert Recommendations for Implementing Change