Figure 2. Protocol Structure: Implementation and Evaluation.

The implementation and evaluation protocol is illustrated for 3 facilities across 3 waves. Implementation consisted of 6 months of intensive facilitation followed by 6 months of step-down support (shaded rows). Facilities were assigned staggered start times for implementation, beginning at approximately 4-month intervals. The evaluative activities are illustrated beneath the implementation activities for each site (unshaded rows). Specifically, population-level hospitalization data were gathered on a quarterly basis from 12 months prior to the start of implementation (PreQ4-PreQ1) and for the 12 months of implementation (Q1-Q4). The veteran interview sample was assessed at the beginning of implementation, after 6 months, and after 12 months of implementation (black dots). Clinician assessment with the Team Development Measure took place at the beginning of facilitation and during step-down support. Thus, all evaluation activities were anchored to the start time of implementation support, considered protocol time zero (t₀) for each site. Q indicates quarter of the year.