Table 1 Processes mapped to established implementation constructs and strategies
From: Expanding access to medications for opioid use disorder through locally-initiated implementation
What happened? | How would this action be classified by CFIR? | Which expert recommendation for initiating change (ERIC) implementation strategy best describes the action? |
|---|---|---|
National policy change | ||
• Clinical practice guideline altered • VA national office published new clinical requirements | Outer setting (external policy and incentives) | Dissemination strategy • Mandate change |
Local actions and initiatives | ||
• Champion participated in multiple, cross-clinic planning meetings • Champion researched intervention | Process (engaging the champion) | Implementation process strategy • Champion activateda |
Within cross-clinic meetings, team: • Mapped current treatment capacity and care-gaps • Shared information • Strengthened communication networks • Promoted collaboration | Inner setting (networks and communication) | Implementation process strategies • Conduct a local needs assessment • Promote network weaving • Build a coalition |
• Launched a process improvement team • Fielded a survey to identify supports needed for intervention | Process (planning) | Implementation process strategy • Assess for readiness and identify barriers and facilitators |
• Identified new staffing source • Redesigned staff roles | Inner setting (available resources) | Integration strategies • Create new clinical teams • Revise professional roles |
• Identified appropriate patient population • Identified a compatible care-delivery model | Inner setting (compatibility) | Integration strategies • Promote adaptability • Tailor strategies |
• Leadership voiced support in a public forum | Inner setting (leadership engagement) | Capacity building strategy • Showcase leadership supportb |
• Hosted a summit to: ○ Brainstorm solutions ○ Solicit public commitment to participate | Process (engaging, learning climate) | Implementation process strategies • Build a coalition • Create a learning collaborative • Obtain formal commitment |
• Launched an E-Consult service | Inner setting (networks and communication, available resource) | Integration strategies • Facilitation • Create new clinical teams • Tailor strategies • Obtain formal commitment • Promote network weaving |