Johnson Joshua K, Sullivan Jennifer L, Trinkley Katy E, Lapin Brittany, Passek Sandra, Asp Valerie, Ford Bryan, Rabin Borsika A
Department of Physical Medicine and Rehabilitation, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Rehabilitation and Sports Therapy, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
PM R. 2024 Jun 27. doi: 10.1002/pmrj.13204.
The iPRISM webtool is an interactive tool designed to aid the process of applying the Practical, Robust Implementation and Sustainability Model (PRISM) for the assessment of and fit with context. A learning community (LC) is a multidisciplinary group of partners addressing a complex problem. Our LC coproduced the Physical TheraPy frEqueNcy Clinical decIsion support tooL (PT-PENCIL) to guide the use of physical therapist services in acute care hospitals.
To describe our LC's activities to co-produce the PT-PENCIL, use of the iPRISM webtool to assess its preimplementation context and fit, and develop a multicomponent implementation strategy for the PT-PENCIL.
A descriptive research design.
Three tertiary care hospitals.
Thirteen LC partners: six clinical physical therapists, three rehabilitation managers, three researchers, and a bioinformaticist.
Not applicable.
Using the iPRISM webtool, expected fit of the PT-PENCIL was rated 1 (not aligned) to 6 (well aligned) for each PRISM domain and expected reach, effectiveness, adoption, implementation, and maintenance were rated 1 (not likely at all) to 6 (very likely). Discrete implementation strategies were identified from the Expert Recommendations for Implementing Change.
The process spanned 18 meetings over 8 months. Ten LC partners completed the iPRISM webtool. PRISM domains with the lowest expected alignment were the "implementation and sustainability infrastructure" (mean = 4.7 out of 6; range = 3-6) and the "external environment" (mean = 4.9 of 6; range = 4-6). Adoption was the outcome with the lowest expected likelihood (mean = 4.5 out of 6; range = 1-6). Six discrete implementation strategies were identified and combined into a multicomponent strategy.
Within a LC, we used existing implementation science resources to co-produce a novel clinical decision support tool for acute care physical therapists and develop a strategy for its implementation. Our methodology can be replicated for similar projects given the public availability of each resource used.
iPRISM网络工具是一种交互式工具，旨在辅助应用实用、稳健实施与可持续性模型（PRISM）来进行评估并与实际情况相匹配。学习社区（LC）是由多学科合作伙伴组成的团队，致力于解决复杂问题。我们的学习社区共同制作了物理治疗频率临床决策支持工具（PT-PENCIL），以指导急性护理医院中物理治疗师服务的使用。
描述我们学习社区共同制作PT-PENCIL的活动，使用iPRISM网络工具评估其实施前的情况和匹配度，并为PT-PENCIL制定多组件实施策略。
描述性研究设计。
三家三级护理医院。
13名学习社区合作伙伴：6名临床物理治疗师、3名康复经理、3名研究人员和1名生物信息学家。
不适用。
使用iPRISM网络工具，针对每个PRISM领域，PT-PENCIL的预期匹配度被评为1（不匹配）至6（非常匹配），预期的覆盖范围、有效性、采用率、实施情况和维持情况被评为1（完全不可能）至6（非常可能）。从实施变革的专家建议中确定了离散的实施策略。
该过程历时8个月，共召开了18次会议。10名学习社区合作伙伴完成了iPRISM网络工具。预期匹配度最低的PRISM领域是“实施与可持续性基础设施”（平均评分为4.7分，满分6分；范围为3 - 6分）和“外部环境”（平均评分为4.9分，满分6分；范围为4 - 6分）。采用率是预期可能性最低的结果（平均评分为4.5分，满分6分；范围为1 - 6分）。确定了六种离散的实施策略，并将其组合成一个多组件策略。
在一个学习社区内，我们利用现有的实施科学资源共同制作了一种针对急性护理物理治疗师的新型临床决策支持工具，并制定了其实施策略。鉴于所使用的每种资源都可公开获取，我们的方法可用于类似项目。
