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Table 3 Specification overview of the multifaceted implementation and sustainment facilitation (ISF) Strategy

From: Testing the implementation and sustainment facilitation (ISF) strategy as an effective adjunct to the Addiction Technology Transfer Center (ATTC) strategy: study protocol for a cluster randomized trial

Discrete implementation strategies:
Defining characteristic according to Proctor et al. [41]
Operational definition of key dimensions for each discrete implementation strategy
Actor(s) Actions(s) Target(s) of
the action
Temporality Dose Targeted implementation outcome(s) Justification
K. Use an improvement and implementation advisor:
Seek guidance from experts in implementation, including consultation with outside experts (e.g., university-affiliated faculty members, quality improvement experts, implementation professionals)
An individual with training and experience in assisting organizations with practice improvement and implementation efforts The overarching implementation strategy that encompasses the other discrete implementation strategies listed below An ASO’s designated staff working on the project (SWOP) team (2 BI staff and 2–4 leadership staff)
Implementation readiness, implementation climate, leadership engagement
The initial kickoff meeting should be held within 1 month of completing the exploration phase See Tables 4, 5 and 6 Fidelity (i.e., proficiency and implementation effectiveness) and sustainment [38, 66,67,68,69]
L. Develop tools for quality improvement:
Develop, test, and introduce quality-improvement tools with inputs (e.g., measures) specific to the innovation being implemented
An individual with training and experience in assisting organizations with practice improvement and implementation efforts Decisional Balance Exercise;
Performance Review, Evaluation, and Planning Exercise; Climate Evaluation and Optimization Exercise
SWOP team.
Implementation readiness, implementation climate, leadership engagement
Finalization of tools for quality improvement (e.g., decisional balance worksheet) should be prior to the initial kickoff meeting See Tables 4, 5 and 6 Fidelity (i.e., proficiency and implementation effectiveness) and sustainment [31, 38, 72, 103, 104]
M. Organize implementation team meetings:
Develop and support teams of clinicians who are implementing the innovation and give them protected time to reflect on the implementation effort, share lessons learned, and support one another’s learning
An individual with training and experience in assisting organizations with practice improvement and implementation efforts Meetings that enable direct interaction between the actors—implementation and sustainment facilitation (ISF) staff— and SWOP team SWOP team.
Implementation readiness, implementation climate, leadership engagement
First implementation team meeting should be held within 1 month of completing the exploration phase See Tables 4, 5 and 6 Fidelity (i.e., proficiency and implementation effectiveness) and sustainment [74, 75]
N. Identify and prepare champions:
Cultivate relationships with people who will champion the clinical innovation and spread the word of the need for it
An individual with training and experience in assisting organizations with practice improvement and implementation efforts Learning about and engaging with the SWOP team SWOP team.
Implementation readiness, implementation climate, leadership engagement
Identification and preparation of champions should begin during the process of organizing the initial implementation team meeting See Tables 4, 5 and 6 fidelity (i.e., proficiency and implementation effectiveness) and sustainment [31, 32, 76, 77]
O. Assess for readiness and identify barriers:
Assess various aspects of an organization to determine its degree of readiness to implement, barriers that may impede implementation, and strengths that can be used in the implementation effort
An individual with training and experience in assisting organizations with practice improvement and implementation efforts Utilization of the ISF exercises described above (L. Develop tools for quality improvement) SWOP team.
Implementation readiness, implementation climate, leadership engagement
Assessments of readiness and identification of barriers should begin during the process of organizing the initial implementation team meeting See Tables 4, 5 and 6 Fidelity (i.e., proficiency and implementation effectiveness) and sustainment [78,79,80,81,82]
P. Conduct local consensus discussions:
Include providers and other stakeholders in discussions that address whether the chosen problem is important and whether the clinical innovation to address it is appropriate
An individual with training and experience in assisting organizations with practice improvement and implementation efforts Completion of an
in-person, stakeholder-engagement and sustainment-planning meeting
SWOP team.
Implementation readiness, implementation climate, leadership engagement
Should be held as soon as possible after the first implementation month has been completed See Tables 4, 5 and 6 Fidelity (i.e., proficiency and implementation effectiveness) and
Sustainment
[83, 84, 105]  
Q. Conduct cyclical small tests of change:
Implement changes in a cyclical fashion using small tests of change
An individual with training and experience in assisting organizations with practice improvement and implementation efforts Completion of study-act-plan-do cycles SWOP team.
Implementation readiness, implementation climate, leadership engagement
Should begin as soon as necessary See Tables 4, 5 and 6 Fidelity (i.e., proficiency and implementation effectiveness) and sustainment [85,86,87]