Table 5.

Strategies to Enhance Implementation Success

Category	Recommended strategies	Actor
Organizational readiness (Birken et al., 2015; Shea, Jacobs, Esserman, Bruce, & Weiner, 2014; Weiner, 2009)	• Assess organizational commitment and capacity to implement prior to implementation	• Implementation Team (which could include administrative and clinical leadership, middle management, frontline staff, and research team members, if it is a research study)
Adoption (Birken et al., 2012; Birken et al., 2013)	• Hire staff with appropriate skills / relevant experience • Establish vertical and horizontal support • Define intervention as new standard of care • Recognize / disseminate intervention benefits • Demonstrate commitment to caring for patients across care continuum • Identify long-term financial benefits	• Administrative and clinical leadership • Implementation Team • Administrative and clinical leadership • Clinical leadership and frontline providers • Implementation Team • Administrative and clinical leadership
Reach (Chhatre et al., 2018)	• Develop a system for identifying and tracking eligible and enrolled patients • Visit patient in the hospital whenever possible • Confirm questionable diagnoses as soon as possible after discharge	• Postacute care coordinator (PAC) and clinical leadership, including middle management (may involve Information Technology) • PAC or back-up frontline staff (when PAC is not available) • PAC or back-up frontline staff
Implementation staffing (Birken et al., 2012, Birken et al., 2013; Leeman, Birken, Powell, Rohweder, & Shea, 2017)	• Include intervention performance metrics as part of regular quality briefings • Maintain consistent and sufficient PAC and APP staff and trained back-up staff is important for fidelity and enhances shared responsibility • Train direct care staff to identify and enroll eligible patients in the absence of the PAC	• Administrative and clinical leadership (may include Performance/ Quality Improvement Team) • Implementation Team • Implementation Team
Patient retention (Chhatre et al., 2018)	• Include follow-up clinic visit in discharge orders and remind patient on 2-day call • Explain the importance of the follow-up clinic visit to the patient • Once identified, include a notification in the patient’s medical record indicating they are receiving the intervention • Collaborate with primary care providers and reinforce purpose of COMPASS-TC • Host follow-up clinic visit in a neurologist office; reinforce that this visit is specialty care to aid long-term recovery	• PAC or APP (may include hospitalist, discharge planners, and case managers) • PAC or APP • PAC or APP (may include hospitalist, discharge planners, and case managers) • Administrative and clinical leadership including PAC and APP • Administrative and clinical leadership
Develop strong community resource networks (Dreyer, 2014)	• Partner with community pharmacists to aid in postdischarge medication management • Work with specialists at the local Area Agency on Aging to identify appropriate community-based follow-up services • Work with community paramedic or other outreach programs to follow-up with “difficult to reach” patients	• PAC and APP in collaboration with administrative and clinical leadership, case managers, and discharge planners • PAC and APP • PAC and APP
Utilize existing web-based resources (Leeman et al., 2017)	• COMPASS-TC website provides multiple resources for patients, caregivers, and providers in NC	• PAC and APP