Baird Sean A, Damush Teresa M, Rattray Nicholas A, Penney Lauren S, Miech Edward J, Homoya Barbara J, Ferguson Jared, Myers Laura J, Bravata Dawn M
Department of Veterans Affairs (VA), Health Services Research (HSR) Expanding Expertise Through E-health Network Development (EXTEND) Quality Enhancement Research Initiative (QUERI) Center, Indianapolis, IN, United States.
Department of Veterans Affairs (VA) Health Systems Research (HSR) Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, Indianapolis, IN, United States.
Front Health Serv. 2025 Jun 10;5:1580653. doi: 10.3389/frhs.2025.1580653. eCollection 2025.
A strategy for transitioning implementation successfully from pre-implementation to active implementation is to hold a team "kickoff." The objectives of this manuscript are: (1) to present the frameworks that guided the development of the Protocol-guided Rapid Evaluation of Veterans Experiencing New Transient neurological symptoms (PREVENT) kickoff strategy, (2) describe design elements of the kickoff and how they contribute to achieving PREVENT kickoff aims; forming teams, developing an action plan, and launching active implementation (3) examine the perceived usefulness of those kickoff design elements toward achieving kickoff aims.
PREVENT was a stepped-wedge trial to improve the quality of Transient Ischemic Attack (TIA) care at six Veterans Affairs (VA) medical centers. The PREVENT kickoff was designed from multiple frameworks: theory of change principles for process improvement; Consolidated Framework for Implementation Research (CFIR); social learning models; and systems redesign. Data collected included pre-kickoff planning documents and post-kickoff debriefs from the PREVENT national team, Audience Response System (ARS) data, post-kickoff site participant evaluations and semi-structured interviews.
Site team participants reflected positively on the framework driven, interactive and interpersonal design elements, team building, and action plan exercises, and found them useful for a successful project launch. In-person and hybrid set-up of the kickoff, interactive elements, and team formation activities emphasized the quality problem, and motivated site implementation providers to plan for stroke/TIA care improvement.
Implementation team kickoffs during pre-implementation are a useful approach to inform and engage local clinical teams and to form plans for practice changes to improve clinical care.
clinicaltrials.gov, identifier NCT02769338.
成功将实施从实施前阶段过渡到积极实施阶段的一个策略是举行团队“启动会”。本手稿的目标是:(1)介绍指导制定退伍军人新发短暂性神经症状快速评估方案(PREVENT)启动策略的框架;(2)描述启动会的设计要素以及它们如何有助于实现PREVENT启动会的目标,即组建团队、制定行动计划并启动积极实施;(3)研究这些启动会设计要素对于实现启动会目标的感知有用性。
PREVENT是一项阶梯楔形试验,旨在提高六个退伍军人事务(VA)医疗中心的短暂性脑缺血发作(TIA)护理质量。PREVENT启动会是根据多个框架设计的:过程改进的变革理论原则、实施研究综合框架(CFIR)、社会学习模型和系统重新设计。收集的数据包括PREVENT国家队的启动会前规划文件和启动会后汇报、观众反应系统(ARS)数据、启动会后现场参与者评估以及半结构化访谈。
现场团队参与者对框架驱动、互动和人际设计要素、团队建设及行动计划练习给予了积极反馈,并发现它们对项目的成功启动很有用。启动会的现场和混合设置、互动要素以及团队组建活动强调了质量问题,并促使现场实施提供者规划改善中风/TIA护理。
实施前的实施团队启动会是一种有用的方法,可让当地临床团队了解情况并参与其中,并制定实践变革计划以改善临床护理。
clinicaltrials.gov,标识符NCT0276933