Table 1.

Detailed Description of the Implementation Strategies Selected Based on Literature and Expert Recommendations^37,38

Implementation strategy	Who enacts the strategy?	What are the actions, steps, or processes enacted?	Who was the implementation target?	When was the strategy used?	What was the dosage of the strategy?
Facilitation	External facilitators	Interact with facility throughout intervention	Local implementation teams	Throughout intervention year	Minimum of one 2-day site visit and monthly calls with as-needed consultation
Conduct local needs assessment	Qualitative core	Interview local stakeholders	Local stakeholders	Prior to site visit	Up to 10 interviews per facility
Identify barriers and facilitators	Qualitative core	Rapid analysis of stakeholder interviews to formulate facility report	Local implementation teams	Prior to site visit	N/A
Capture and share local knowledge	External facilitators	Review of local facility report with local implementation teams	Local implementation teams	During site visit	2 h during site visit dedicated to reviewing and verifying site report
Identify and prepare champions	External facilitators	Champions identified through pre-intervention interviews, site visit planning process, and interactions during site visit	Local stakeholders	Prior to and during site visit	N/A
Conduct educational meetings	Clinical expert	Requested educational offerings presented during site visit	Facility clinicians	During site visit	8 h during site visit
Organize clinician implementation meetings	External facilitators	Facility coaching calls; cross-facility community of practice calls	Facility implementation teams	Facility: during facility intervention year Cross-facility: while any sites were active in intervention	Facility: 1/month × 12 months Cross-facility: 1/quarter × 8 quarters*
Audit and feedback	External facilitators	Provide facility implementation team with report of main implementation outcomes	Facility implementation teams	During facility intervention year	Quarterly for 4 quarters
Change in credentialing or licensure standards	External facilitators along with VHA national leadership	Release of national notification instructing facilities not to place additional credentialing/privileging requirements on new prescribers beyond documentation of X-waiver	Credentialing and privileging departments at VHA facilities	Notification published October 2019	N/A
Develop/distribute educational materials	External facilitators	Facilitators compiled a large library of print and online materials addressing various educational needs; provided to facilities as requested to address knowledge gaps	Facility implementation teams and clinicians	Throughout intervention period	As requested
Provide ongoing consultation	Clinical expert	Clinical expert available as needed to consult regarding clinical care	Facility clinicians	Throughout intervention period	As requested
Tailor strategies	External facilitators	External facilitators used information from site reports, site visits, and facilitation calls to identify barriers to implementation and provide facilities with needed resources	Facility implementation team and clinicians	Throughout intervention period	N/A

^*Cross-facility conference calls ran from 3 months after the first sites started the intervention until the last site completed the intervention for a total of 8 calls in 24 months