Table 3.
Blueprint for pre-implementation
| Importance | Goal | Responsible | Feasibility | Impact | Implementation category | Action step |
|---|---|---|---|---|---|---|
| H | 1, 2, 3 | IT | H | 3 | Develop stakeholder interrelationships | Implementation team––reserve biweekly meetings |
| H | 1, 3 | IT | L | 1.5 | Support clinicians | Restructure clinical teams |
| H | 3 | B | H | 2 | Train and educate stakeholders | Select training methods that fit preferences of staff |
| H | 1, 2, 3 | IT | L | 3 | Develop stakeholder interrelationships | Recruit, designate, and train for leadership (pick chair/lead) |
| H | 3 | B/IT | L | 3 | Adapt and tailor to context | Fit intervention to clinical practice (link points and levels with CBT and outcome monitoring) |
| H | 1, 3 | B/IT | Use evaluative and iterative strategies | Develop and implement tools for quality monitoring (identify program level measures) | ||
| M | 3 | B | H | 1 | Develop stakeholder interrelationships | Develop implementation glossary |
| M | 3 | B | H | 1 | Develop stakeholder interrelationships | Develop structured referral sheets |
| L | 3 | B | L | 2 | Train and educate stakeholders | Prepare client-facing psychoeducational materials regarding mental health problems |
| M | 1 | IT | L | 3 | Utilize financial strategies | Shift resources for incentives, support and to reduce turnover |
| M | 1, 2 | B/IT | H | 2 | Develop stakeholder interrelationships | Conduct local consensus discussions––mix with educational meetings |
| L | 1, 2 | IT | H | 1 | Train and educate stakeholders | Conduct educational meetings |
| L | 3 | IT | L | 2 | Change infrastructure | Modify context to prompt new behaviors––change note template |
| M | 3 | B/IT | L | 3 | Utilize financial strategies | Access new funding |
“Importance” contains “H” for “High” (i.e., strategy must be enacted because it targets a highly important barrier), “M” for “Moderate” (i.e., the strategy should be prioritized if resources are available), or an “L” for “Low” (i.e., strategy should only be enacted if time and resources are available). “Goal” contains a 1, 2, or 3 to indicate which of the top 3 goals the strategy would primarily target. “Responsible” reflects whether the strategy should be enacted by the “IT” (i.e., Implementation Team at Wolverine Human Services) or “B” (i.e., Beck Institute or other external experts). “Feasibility” contains either “H” for “High” or “L” for “Low” in terms of the ease with which a given strategy could be enacted. “Impact” contains a score from 1 to 3 to reflect the degree to which the strategy would likely impact the fidelity with which CBT would be delivered. “Implementation Category” is derived from an expert-engaged concept mapping exercise in which nine conceptually distinct categories emerged: adapt and tailor to the context, change infrastructure, develop stakeholder interrelationships, engage consumers, provide interactive assistance, support clinicians, train and educate stakeholders, utilize financial strategies, and use evaluative and iterative strategies. Implementation strategy contains the name of the strategy to be enacted. Timeline: Revisit in 6–8 months (truncated surveys, focus groups)
Note. Goals: 1 improve climate, satisfaction, communication, and teamwork; 2 re-establish consistency/quality of physical restraints; 3 Prep materials to support CBT