Learning Collaboratives: a Strategy for Quality Improvement and Implementation in Behavioral Health

Gotham, Heather J.; Paris, Manual; Hoge, Michael A.

doi:10.1007/s11414-022-09826-z

Cited by 13 publications

(14 citation statements)

References 60 publications

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“…Although the majority stated that receiving instructions through collaborative learnings increased their knowledge and, in turn, improved their guideline use, the multivariate regression analysis did not show a signi cant in uence on practitioners' self-reported implementation performance. This latter nding contrasts with previous research on collaborative learnings and guideline implementation in health care [22][23][24][25]. An explanation for this might be that in the current study, we also took the in uence of knowledge increase into account.…”

Section: Figure 6] Discussioncontrasting

confidence: 82%

Optimizing Implementation: Elucidating the Role of Behavior Change Techniques and Corresponding Strategies on Determinants and Implementation Performance: A Cross-Sectional Study

Dubbeldeman,

Crone,

Jong

et al. 2024

Preprint

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Method We performed a cross-sectional study among practitioners and management professionals working in youth (health)care organizations. Using questionnaires, we obtained data regarding the presence and perceived value of BCT-strategy combinations and the association between BCT-strategy combinations and determinants and ultimately, implementation performance. Chi-squared tests and multivariate regression analyses were performed to determine whether determinants and implementation performance were influenced by specific BCT-strategy combinations. Results Data from 104 practitioners and 34 management professionals were used for analyses. Most of the management professionals stated that the BCT-strategy combinations (could) positively affect(ed) their implementation performance. Results on practitioners’ level showed that half of the implementation hypotheses could be confirmed. Practitioners who reported an absence of BCT-strategy combinations were skeptical regarding their potential influence on determinants and implementation performance. Conclusion Several BCT-strategy combinations were found to improve or have the potential to improve the implementation performance of both practitioners and management professionals. When developing and evaluating implementation efforts, we recommend clearly describing the goal of the implementation effort and using frameworks that include a description of both the BCTs that will elicit behavior change, the strategy to achieve this, as well as the mechanisms that drive the observed changes in behavior or outcomes. Understanding the interconnected process between BCTs and strategies, and how they influence determinants, is important for designing targeted and evidence-based behavior change interventions. This understanding is key to optimizing resource allocation and ultimately contributing to the overall success of implementation efforts in youth care.

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Section: Figure 6] Discussioncontrasting

confidence: 82%

Optimizing Implementation: Elucidating the Role of Behavior Change Techniques and Corresponding Strategies on Determinants and Implementation Performance: A Cross-Sectional Study

Dubbeldeman,

Crone,

Jong

et al. 2024

Preprint

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“…The field emerged in response to the understanding that there was a significant gap between establishment of evidence for innovations (e.g., new therapies) and their uptake in routine clinical practice ( 39 ). In addition to studying the methods and strategies that promote uptake, investigators have created and/or fostered use of publicly available resources for other implementation scientists [i.e., free measure repositories ( 40 )] and practitioners or those responsible for initiating change or increasing use of innovations in real-world settings [i.e., Learning Collaboratives and Communities of Practice ( 41 )]. Such resources contribute to collective learning.…”

Section: Discussionmentioning

confidence: 99%

Building a sharable literature collection to advance the science and practice of implementation facilitation

Ritchie,

Smith,

Kim

et al. 2024

Front. Health Serv.

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BackgroundImplementation science seeks to produce generalizable knowledge on strategies that promote the adoption and sustained use of evidence-based innovations. Literature reviews on specific implementation strategies can help us understand how they are conceptualized and applied, synthesize findings, and identify knowledge gaps. Although rigorous literature reviews can advance scientific knowledge and facilitate theory development, they are time-consuming and costly to produce. Improving the efficiency of literature review processes and reducing redundancy of effort is especially important for this rapidly developing field. We sought to amass relevant literature on one increasingly used evidence-based strategy, implementation facilitation (IF), as a publicly available resource.MethodsWe conducted a rigorous systematic search of PubMed, CINAHL, and Web of Science citation databases for peer-reviewed, English-language articles with “facilitation” and a combination of other terms published from January 1996 to December 2021. We searched bibliographies of articles published from 1996 to 2015 and identified articles during the full text review that reported on the same study. Two authors screened 3,168 abstracts. After establishing inter-rater reliability, they individually conducted full-text review of 786 relevant articles. A multidisciplinary team of investigators provided recommendations for preparing and disseminating the literature collection.FindingsThe literature collection is comprised of 510 articles. It includes 277 empirical studies of IF and 77 other articles, including conceptual/theoretical articles, literature reviews, debate papers and descriptions of large-scale clinical initiatives. Over half of the articles were published between 2017 and 2021. The collection is publicly available as an Excel file and as an xml file that can be imported into reference management software.ConclusionWe created a publicly accessible collection of literature about the application of IF to implement evidence-based innovations in healthcare. The comprehensiveness of this collection has the potential to maximize efficiency and minimize redundancy in scientific inquiry about this strategy. Scientists and practitioners can use the collection to more rapidly identify developments in the application of IF and to investigate a wide range of compelling questions on its use within and across different healthcare disciplines/settings, countries, and payer systems. We offer several examples of how this collection has already been used.

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“…27 , 28 The multidisciplinary CQI teams were provided mentorship on the application of CQI principles and tools by MhINT CQI Advisors and Mentors at agreed upon intervals. Learning sessions, which are platforms for reviewing implementation progress, troubleshoot cross‐cutting challenges, and learn additional CQI techniques 30 were scheduled quarterly to promote learning and fast‐track scale up of effective practices.…”

Section: Methodsmentioning

confidence: 99%

Collaborative implementation of an evidence‐based package of integrated primary mental healthcare using quality improvement within a learning health systems approach: Lessons from the Mental health INTegration programme in South Africa

Gigaba,

Luvuno,

Bhana

et al. 2023

Learning Health Systems

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IntroductionThe treatment gap for mental health disorders persists in low‐ and middle‐income countries despite overwhelming evidence of the efficacy of task‐sharing mental health interventions. Key barriers in the uptake of these innovations include the absence of policy to support implementation and diverting of staff from usual routines in health systems that are already overstretched. South Africa enjoys a conducive policy environment; however, strategies for operationalizing the policy ideals are lacking. This paper describes the Mental health INTegration Programme (MhINT), which adopted a health system strengthening approach to embed an evidence‐based task‐sharing care package for depression to integrate mental health care into chronic care at primary health care (PHC).MethodsThe MhINT care package consisting of psycho‐education talks, nurse‐led mental health assessment, and a structured psychosocial counselling intervention provided by lay counsellors was implemented in Amajuba district in KwaZulu‐Natal over a 2‐year period. A learning health systems approach was adopted, using continuous quality improvement (CQI) strategies to facilitate embedding of the intervention.MhINT was implemented along five phases: the project phase wherein teams to drive implementation were formed; the diagnostic phase where routinely collected data were used to identify system barriers to integrated mental health care; the intervention phase consisting of capacity building and using Plan‐Do‐Study‐Act cycles to address implementation barriers and the impact and sustaining improvement phases entailed assessing the impact of the program and initiation of system‐level interventions to sustain and institutionalize successful change ideas.ResultsIntegrated planning and monitoring were enabled by including key mental health service indicators in weekly meetings designed to track the performance of noncommunicable diseases and human immunovirus clinical programmes. Lack of standardization in mental health screening prompted the validation of a mental health screening tool and testing feasibility of its use in centralized screening stations. A culture of collaborative problem‐solving was promoted through CQI data‐driven learning sessions. The province‐level screening rate increased by 10%, whilst the district screening rate increased by 7% and new patients initiated to mental health treatment increased by 16%.ConclusionsThe CQI approach holds promise in facilitating the attainment of integrated mental health care in resource‐scarce contexts. A collaborative relationship between researchers and health system stakeholders is an important strategy for facilitating the uptake of evidence‐based innovations. However, the lack of interventions to address healthcare workers' own mental health poses a threat to integrated mental health care at PHC.

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Learning Collaboratives: a Strategy for Quality Improvement and Implementation in Behavioral Health

Cited by 13 publications

References 60 publications

Optimizing Implementation: Elucidating the Role of Behavior Change Techniques and Corresponding Strategies on Determinants and Implementation Performance: A Cross-Sectional Study

Optimizing Implementation: Elucidating the Role of Behavior Change Techniques and Corresponding Strategies on Determinants and Implementation Performance: A Cross-Sectional Study

Building a sharable literature collection to advance the science and practice of implementation facilitation

Collaborative implementation of an evidence‐based package of integrated primary mental healthcare using quality improvement within a learning health systems approach: Lessons from the Mental health INTegration programme in South Africa

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