QUERI – Quality Enhancement Research Initiative

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Behavioral Health QUERI Implementation Facilitation Training Hub

Little Rock, AR

Principal Investigator: JoAnn Kirchner, MD  JoAnn.Kirchner@va.gov

Implementation facilitation (IF) bundles an integrated set of activities to support the uptake of effective healthcare practices, including but not limited to: engaging stakeholders, identifying champions, action planning, staff training, academic detailing, problem-solving, providing technical support, audit/feedback, and marketing.

Overview:

An increasing volume of literature supports implementation facilitation as an evidence-based strategy for implementing evidence-based practices (EBPs) and other clinical innovations. Systematic reviews have found that primary care practices were almost three times more likely to adopt evidence-based guidelines through the use of facilitation, and multiple studies both inside and outside VA show IF to be an effective strategy for implementing new clinical programs/practices.

As evidence for the effectiveness of IF grows, so has the demand for IF training from VHA operations leaders and research staff. Guided by the integrated–Promoting Action on Research Implementation in Health Services (i-PARIHS) framework, QUERI for Team-Based Behavioral Health (BH-QUERI) National Program investigators have developed substantial experience and expertise in applying and testing the impact of IF strategies to support the implementation of EBPs and other clinical innovations. Over the course of more than eight years, BH-QUERI investigators have systematically worked to transfer this knowledge to VA healthcare leaders, frontline clinical managers, other QUERI/VA researchers, and non-VA researchers through the development and ongoing refinement of their IF Training Program. To date, this work has been done as an ‘add-on’ to BH-QUERI’s

Objectives:

Specific objectives for Behavioral Health (BH) QUERI include:

  • Providing implementation facilitation training to VA and non-VA trainees to improve knowledge of and confidence in using IF to implement evidence-based practices and other clinical innovations;
  • Conducting independent evaluation to assess the impact on trainee’s IF knowledge and skills and identifying training strategies and resources that work well, as well as areas for improvement;
  • Developing, piloting, and evaluating virtual IF training components (i.e., new tools and resources); and
  • Revising and updating the IF Training Program to integrate new knowledge.

Anticipated Impacts:

As evidence for the positive impact of IF strategies in supporting the implementation of evidence-based practices becomes increasingly robust, the Behavioral Health QUERI Implementation Facilitation Training Hub will continue to prepare VA personnel to apply IF strategies in support of high-priority clinical initiatives (e.g., REACH-Vet for suicide prevention, medication-assisted treatment for opioid use disorders) and other VA quality improvement and research efforts.