ObjectiveInternational collaboration in science has received increasing attention given emphases on relevance, generalizability, and impact of research. Implementation science (IS) is a growing discipline that aims to translate clinical research findings into health services. Research is needed to identify efficient and effective ways to foster international collaboration in IS. Concept-mapping (CM) was utilized with a targeted sample for preliminary exploration of fostering international collaboration. Concept-mapping is a mixed-method approach (qualitative/quantitative) particularly suited for identifying essential themes and action items to facilitate planning among diverse stakeholders. We sought to identify key factors likely to facilitate productive and rewarding international collaborations in implementation research.ResultsWe identified eleven dimensions: Strategic Planning; Practicality; Define Common Principles; Technological Tools for Collaboration; Funding; Disseminate Importance of Fostering International Collaboration in IS; Knowledge Sharing; Innovative & Adaptive Research; Training IS Researchers; Networking & Shared Identity; Facilitate Meetings. Strategic Planning and Funding were highest rated for importance and Strategic Planning and Networking and Shared Identity were rated most feasible to institute. Fostering international collaboration in IS can accelerate the efficiency, relevance, and generalizability of implementation research. Strategies should be developed and tested to improve international collaborations and engage junior and experienced investigators in collaborations advancing implementation science and practice.
Rationale, aims, and objectives
The patient‐centred medical home (PCMH) is an innovative approach to health care reform. Despite a well‐established process for recognizing PCMH practices, fidelity to, and/or adaptation of, the PCMH model can limit health care and population health improvements. This study explored the connection between fidelity/adaptation to the PCMH model with implementation successes and challenges through the experiences of family and internal medicine PCMH physicians.
Methods
Interviews were conducted at two academic PCMH clinics with faculty and resident physicians. Data were transcribed and coded on the basis of an a priori code list. Together, the authors reviewed text and furthered the analysis process to reach final interpretation of the data.
Results
Ten faculty and nine resident physicians from the Family Care Centre (FCC; n = 11) and the Internal Medicine Clinic (IMC; n = 8) were interviewed. Both FCC and IMC physicians spoke positively about their clinic's adherence to the PCMH model of enhanced access to care, coordinated/integrated care, and improvements in quality and safety through data collection and documentation. However, physicians highlighted inadequate staffing and clinic hours. FCC physicians also discussed the challenge of providing high‐quality care amidst differences in coverage between payers.
Conclusion
There remains significant variability in PCMH characteristics across the United States and Canada. This qualitative analysis uncovered factors contributing to fidelity/adaptation to the PCMH model in two academic PCMH clinics. For the PCMH to achieve the Triple Aim promise of improved patient health and experience at a reduced cost, policy must support fidelity to core elements of the PCMH.
This study aimed to identify factors associated with implementation of cognitive behavioral social skills training (CBSST) on assertive community treatment (ACT) teams in a large public sector behavioral health system. This study used concept mapping (a mixed-method approach) and involved a sample including diverse stakeholder participants including patients, ACT team members, team leaders, organization leaders, and system leaders. We identified 14 distinct issues related to implementing CBSST on ACT teams: (a) CBSST fit with ACT structure, (b) CBSST fit with ACT process, (c) provider perceptions about CBSST, (d) staff pressures/other demands; (e) CBSST and ACT synergy, (f) client characteristics, (g) benefits of CBSST, (h) coordination/interaction among ACT providers, (i) government/regulatory factors, (j) integration of CBSST into ACT, (k) training support, (l) training resources, (m) multilevel agency leadership, and (n) provider characteristics. Each of these dimensions were rated in regard to importance and changeability with the top 5 rated dimensions including effective training support; alignment of leadership across levels of the community-based organizations delivering services; perceived benefits of CBSST, CBSST and ACT synergy; and provider perceptions of CBSST. The most critical issues for CBSST implementation on ACT teams should be addressed in future studies. Implementation strategies that capitalize on enhancing leadership and organizational climate hold promise to address all of these issues.
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