BACKGROUND
Researchers have conducted numerous studies seeking to understand how to improve implementation of changes in healthcare organizations, but less focus has been given to applying lessons already learned from implementation science to current projects. Finding innovative ways to apply these findings efficiently will improve current research on implementation strategies and will allow organizations utilizing these techniques to make changes more easily.
OBJECTIVE
This research seeks to compare a practical implementation approach that uses principles from prior implementation studies to more traditional ways of implementing change to further understand this issue.
METHODS
Forty-three addiction treatment sites in Iowa were randomly assigned to two different implementation strategies in a randomized comparative effectiveness trial studying implementation of an e-health substance use disorder (SUD) treatment technology. One strategy used an adaptation of the NIATx improvement approach developed for use in addiction treatment organizations, while the other utilized a traditional product training model. This paper discusses lessons learned from interviews with clinicians at these organizations and other informal feedback gathered throughout the study.
RESULTS
Use of the NIATx approach led to improved outcomes on several measures, including initial and sustained use of new technology by both counselors and patients. Additionally, feedback from clinicians and organizations indicates that utilizing strategies like ensuring that changes address current challenges and outlining how it does so, integrating organizational changes into workflows, and utilizing coaching to overcome hurdles and assess progress are important to improving implementation projects.
CONCLUSIONS
At this interim point in the study, it seems clear that use of the NIATx improvement process leads to better outcomes in implementation of changes within healthcare organizations. However, some strategies utilized in this improvement process are more useful and should be drawn on more heavily in future implementation efforts.
CLINICALTRIAL
ClinicalTrials.gov, NCT03954184. Registered 17 May 2019.