Table 1 Distinct SAIA-MH implementation strategies coded to the Expert Recommendations for Implementing Change (ERIC) framework [31]

External facilitation

Lack of knowledge of quality improvement and SAIA-MH implementation strategy

Provide ongoing clinical consultation

Clinical knowledge gaps; gaps in clinical evaluation and reporting

Organize service provider implementation team meetings

Limited teamwork: lower-level providers afraid to innovate without approval; siloing of services and providers; issues with role clarity

Step 1: Cascade analysis (ERIC: Audit and feedback; Model and simulate change; facilitate relay of clinical data to providers)

Lack of knowledge of problems; no data for prioritization; data only collected/reported but limited feedback; limited accountability

Step 2: Process mapping (ERIC: Conduct local needs assessment; assess readiness for change and identify barriers/facilitators; conduct local consensus discussions)

Lack of consensus on current system; limited teamwork; limited discussion on full system, goals, barriers, and facilitators; hard to conceptualize potential modifications

Steps 3–5: Conduct cyclical tests of change (ERIC: Conduct cyclical small tests of change; tailor strategies; develop a formal implementation blueprint; purposely reexamine the implementation)

Limited culture of quality; providers rigidly follow guidelines with no ability to innovate and improve