Table 1 Survey user validity concerns
Original generic ERIC strategies | Tailored to hepatitis C ERIC strategies | Wording | Concept | Similarity | Other | Total |
|---|---|---|---|---|---|---|
Change infrastructure | ||||||
11. Change physical structure and equipment | 1. Change physical structure and equipmenta | 3 | 3 | 0 | 1 | 7 |
12. Change record systems | 2. Change the record systems | 2 | 5 | 1 | 1 | 9 |
13. Change service sites | 3. Change the location of clinical service sites | 0 | 0 | 0 | 0 | 0 |
62. Start a dissemination organization | 4. Develop a separate organization or group responsible for disseminating HCV care | 0 | 1 | 0 | 0 | 1 |
44. Mandate change | 5. Mandate changes to HCV care | 1 | 3 | 0 | 1 | 5 |
22. Create or change credentialing and/or licensure standards | 6. Create or change credentialing and/or licensure standardsb | 1 | 4 | 0 | 1 | 6 |
10. Change liability laws | 7. Participate in liability reform efforts that make clinicians more willing to deliver the clinical innovation | 1 | 4 | 0 | 2 | 7 |
9. Change accreditation or membership requirements | 8. Change accreditation or membership requirementsb | 1 | 5 | 1 | 1 | 8 |
Financial strategies | ||||||
1. Access new funding | 9. Access new fundinga | 0 | 2 | 1 | 1 | 4 |
2. Alter incentive/allowance structures | 10. Alter incentive/allowance structures | 2 | 3 | 0 | 2 | 7 |
28. Develop disincentives | 11. Provide financial disincentives for failure to implement or use the clinical innovations | 0 | 0 | 0 | 4 | 4 |
34. Fund and contract for the clinical innovation | 12. Respond to proposals to deliver HCV care | 1 | 2 | 0 | 0 | 3 |
42. Make billing easier | 13. Change billing | 1 | 3 | 0 | 6 | 10 |
49. Place innovation on fee for service lists/formularies | 14. Place HCV medications on the formulary | 0 | 0 | 0 | 1 | 1 |
3. Alter patient/consumer fees | 15. Alter patient fees | 1 | 2 | 2 | 5 | 10 |
66. Use capitated payments | 16. Use capitated payments | 2 | 4 | 0 | 5 | 11 |
70. Use other payment schemes | 17. Use other payment schemes | 2 | 3 | 1 | 5 | 11 |
Support clinicians | ||||||
21. Create new clinical teams | 18. Create new clinical teams | 0 | 0 | 0 | 0 | 0 |
32. Facilitate relay of clinical data to providers | 19. Facilitate the relay of clinical data to providersb | 0 | 0 | 0 | 0 | 0 |
59. Revise professional roles | 20. Revise professional roles | 0 | 0 | 0 | 1 | 1 |
58. Remind clinicians | 21. Develop reminder systems for clinicians | 0 | 0 | 1 | 1 | 2 |
30. Develop resource sharing agreements | 22. Develop resource sharing agreements | 0 | 3 | 0 | 0 | 3 |
Provide interactive assistance | ||||||
33. Facilitation | s23. Use outside assistance often called “facilitation” | 2 | 3 | 1 | 1 | 7 |
54. Provide local technical assistance | s24. Have someone from inside the clinic/center (“local technical assistance”) tasked with assisting the clinicb | 0 | 2 | 2 | 0 | 4 |
53. Provide clinical supervision | 25. Provide clinical supervisionb | 0 | 1 | 0 | 0 | 1 |
8. Centralize technical assistance | 26. Use a centralized system to deliver facilitation | 3 | 3 | 2 | 0 | 8 |
Adapt and tailor to context | ||||||
67. Use data experts | 27. Use data experts to manage HCV data | 0 | 0 | 2 | 0 | 2 |
68. Use data warehousing techniques | 28. Use data warehousing techniques | 2 | 2 | 2 | 0 | 6 |
63. Tailor strategies | 29. Tailor strategies to deliver HCV care | 0 | 2 | 1 | 0 | 3 |
51. Promote adaptability | 30. Promote adaptabilityb | 0 | 4 | 1 | 1 | 6 |
Train and educate stakeholders | ||||||
15. Conduct educational meetings | 31. Conduct educational meetingsb | 0 | 0 | 2 | 0 | 2 |
16. Conduct educational outreach visits | 32. Have an expert in HCV care meet with providers to educate themb | 0 | 0 | 2 | 0 | 2 |
19. Conduct ongoing training | 33. Provide ongoing HCV trainingb | 0 | 0 | 2 | 0 | 2 |
20. Create a learning collaborative | 34. Facilitate the formation of groups of providers and fostered a collaborative learning environment | 0 | 0 | 2 | 0 | 2 |
29. Develop educational materials | 35. Developed formal educational materialsb | 0 | 0 | 2 | 0 | 2 |
31. Distribute educational materials | 36. Distribute educational materials | 0 | 0 | 3 | 0 | 3 |
55. Provide ongoing consultation | 37. Provide ongoing consultation with one or more HCV treatment experts | 1 | 0 | 1 | 0 | 2 |
71. Use train-the-trainer strategies | 38. Train designated clinicians to train othersb | 0 | 0 | 1 | 0 | 1 |
43. Make training dynamic | 39. Vary the information delivery methods to cater to different learning styles when presenting new information | 0 | 0 | 0 | 1 | 1 |
60. Shadow other experts | 40. Give providers opportunities to shadow other experts in HCV | 1 | 0 | 0 | 0 | 1 |
73. Work with educational institutions | 41. Use educational institutions to train clinicians | 3 | 1 | 2 | 0 | 6 |
Develop stakeholder relationships | ||||||
6. Build a coalition | 42. Build a local coalition/team to address challenges | 0 | 0 | 1 | 2 | 3 |
17. Conduct local consensus discussions | 43. Conduct local consensus discussionsb | 2 | 3 | 0 | 1 | 6 |
47. Obtain formal commitments | 44. Obtain formal written commitments from key partners that state what they will do to implement HCV care | 0 | 0 | 0 | 2 | 2 |
57. Recruit, designate, and train for leadership | 45. Recruit, designate, and/or train leaders | 0 | 0 | 1 | 0 | 1 |
38. Inform local opinion leaders | 46. Inform local opinion leaders about advances in HCV care | 1 | 3 | 3 | 1 | 8 |
7. Capture and share local knowledge | 47. Share the knowledge gained from quality improvement efforts with other sites outside your medical centera | 0 | 0 | 0 | 1 | 1 |
35. Identify and prepare champions | 48. Identify and prepare championsa | 0 | 1 | 0 | 0 | 1 |
48. Organize clinician implementation team meetings | 49. Organize support teams of clinicians, give them time to share the lessons learned and support one another’s learninga | 0 | 1 | 2 | 0 | 3 |
64. Use advisory boards and workgroups | 50. Use advisory boards and interdisciplinary workgroups to provide input into HCV policies and elicit recommendations | 0 | 0 | 2 | 1 | 3 |
65. Use an implementation advisor | 51. Seek the guidance of experts in implementationa | 0 | 1 | 1 | 1 | 3 |
52. Promote network weaving | 52. Build on existing high-quality working relationships and networks to promote information sharing and problem solvingb | 0 | 0 | 1 | 0 | 1 |
45. Model and simulate change | 53. Use modeling or simulated changeb | 1 | 5 | 0 | 0 | 6 |
24. Develop academic partnerships | 54. Partner with a university to share ideas | 0 | 0 | 0 | 1 | 1 |
36. Identify early adopters | 55. Make efforts to identify early adopters to learn from their experiencesb | 0 | 1 | 0 | 0 | 1 |
72. Visit other sites | 56. Visit other sites outside your medical center to try to learn from their experiences | 0 | 0 | 1 | 0 | 1 |
25. Develop an implementation glossary | 57. Develop an implementation glossary | 1 | 4 | 0 | 2 | 7 |
40. Involve executive boards | 58. Involve executive boards | 0 | 1 | 2 | 0 | 3 |
Use evaluative and iterative strategies | ||||||
4. Assess for readiness and identify barriers and facilitators | 59. Assess for readiness and identify barriers and facilitators to change | 0 | 0 | 0 | 1 | 1 |
18. Conduct local needs assessment | 60. Conduct a local needs assessmenta | 0 | 0 | 0 | 0 | 0 |
23. Develop a formal implementation blueprint | 61. Develop a formal implementation blueprint | 0 | 2 | 0 | 1 | 3 |
61. Stage implementation scale up | 62. Start with small pilot studies and then scale them up | 0 | 0 | 1 | 0 | 1 |
5. Audit and provide feedback | 63. Collect and summarize clinical performance data and give it to clinicians and administrators to implement changes in a cyclical fashion using small tests of change before making system-wide changes | 0 | 0 | 3 | 0 | 3 |
14. Conduct cyclical small tests of change | 64. Conduct small tests of change, measured outcomes, and then refine these testsb | 0 | 0 | 3 | 0 | 3 |
26. Develop and implement tools for quality monitoring | 65. Develop and use tools for quality monitoring | 0 | 0 | 1 | 2 | 3 |
27. Develop and organize quality monitoring systems | 66. Develop and organize systems that monitor clinical processes and/or outcomes for the purpose of quality assurance and improvementa, b | 0 | 0 | 1 | 0 | 1 |
56. Purposely reexamine the implementation | 67. Intentionally examine the efforts to promote HCV carea,b | 1 | 2 | 2 | 0 | 5 |
46. Obtain and use patients/consumers and family feedback | 68. Develop strategies to obtain and use patient and family feedback | 0 | 0 | 0 | 0 | 0 |
Engage consumers | ||||||
41. involve patients/consumers and family members | 69. Involve patients/consumers and family membersa,b | 0 | 1 | 0 | 0 | 1 |
50. Prepare patients/consumers to be active participants | 70. Engage in efforts to prepare patients to be active participants in HCV careb | 0 | 0 | 0 | 0 | 0 |
39. Intervene with patients/consumers to enhance uptake and adherence | 71. Intervene with patients/consumers to promote uptake and adherence to HCV treatmentb | 0 | 0 | 0 | 0 | 0 |
69. Use mass media | 72. Use mass media to reach large numbers of peopleb | 0 | 1 | 0 | 1 | 2 |
37. Increase demand | 73. Promote demand for HCV care among patients through any other means | 0 | 1 | 0 | 0 | 1 |