Table 1.
Outline of implementation actions by comparison group
| Implementation actions: goals and concrete strategies | Comparison Groups (Target agents) | |
|---|---|---|
| Facilitated community of practice | ||
| Goals : to facilitate a collaborative learning environment to improve the implementation of clinical innovation. Concrete implementation strategies: Create a learning collaborative, Facilitation in the form of outreach visits |
Global
Intergroup partnership and Relationship building |
Sequential
Pragmatic cooperation |
|
Strengthening of Local Leadership
Goals : to provide the local coordinator with skills in primary prevention of T2D and interpersonal and organisational strategies to support the implementation. Concrete implementation strategies : Recruit, designate and train for leadership; Educational meetings. | ||
| 3 training sessions (5 hours/session) | Local leaders for global strategy |
Local leaders for sequential strategy |
|
Training in clinical intervention
Goals : to provide initial training in recommended effective clinical intervention for the prevention of T2D and in how to use the information technology support tool in the electronic health record. Concrete implementation strategies : Educational and capacitation meetings; Changes in record systems | ||
|
Session 1: Primary prevention of T2D in PHC: evidence and recommended practice (90 min) Session 2: Computer application for the promotion of healthy habits in the Electronic Health Record (6 hours) |
Doctors and Nurses | Nurses |
|
Collaborative structuring of the programme
Goals: to plan the local programme based on shared decision-making concerning: objectives, actions, agents, work flow, organisation and sharing out of tasks. Concrete implementation strategies: Local needs assessment; Educational and outreach meetings eliciting local consensus discussion; Ongoing training; Cyclical small tests of change; Develop a formal implementation blueprint | ||
| Session 3 – Needs assessment and prioritisation of areas for improvement in T2D prevention (90 min) | ||
|
Session 4/5 – Planning T2D prevention programme (180 min) Session 6: Plan-Do-Study-Act cycle 1 (90 min) |
Nurses (Prescription→Screening) |
|
| Session 7: Plan-Do-Study-Act cycle 2 (90 min) | Doctors and Nurses (Screening→Prescription) |
|
| Session 8: Refresher training (180 min) | Doctors and Nurses (from the 2nd pilot*) |
|
| Session 9: Plan-Do-Study-Act cycle 3 (90 min) | ||
| Session 10: Final standardisation of the local T2D prevention programme (90 min) | ||
|
Ongoing sustainability
Goals : to continually support and assess innovation being put into practice. Concrete implementation strategies : Develop quality monitoring systems; Audit and provide Feedback; Ongoing training | ||
| Regular audits and ongoing facilitation: 6 follow-up sessions over the course of 12 months (90 min X 6 sessions) Continuing education in clinical intervention and information technology tools |
All participating professionals | |
*A more extensive session lasting 120 min is required to share information about the preliminary programme, suggest pragmatic cooperation and organise the second pilot (2nd PDSA)
Bolded text refers to an implementation action (composed of multiple concrete implementation strategies responding to a implementation goal) or to the work sessions to be held within an implementation action
Underlined text refers to implementation goals or concrete implementation strategies pertaining to an implementation action