Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Implementation Science
Published in: Implementation Science 1/2008

Open Access 01-12-2008 | Methodology

A process for developing an implementation intervention: QUERI Series

Authors: Geoffrey M Curran, Snigda Mukherjee, Elise Allee, Richard R Owen

Published in: Implementation Science | Issue 1/2008

Login to get access

Abstract

Background

This article describes the process used by the authors in developing an implementation intervention to assist VA substance use disorder clinics in adopting guideline-based practices for treating depression. This article is one in a Series of articles documenting implementation science frameworks and tools developed by the U.S. Department of Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI).

Methods

The process involves two steps: 1) diagnosis of site-specific implementation needs, barriers, and facilitators (i.e., formative evaluation); and 2) the use of multi-disciplinary teams of local staff, implementation experts, and clinical experts to interpret diagnostic data and develop site-specific interventions. In the current project, data were collected via observations of program activities and key informant interviews with clinic staff and patients. The assessment investigated a wide range of macro- and micro-level determinants of organizational and provider behavior.

Conclusion

The implementation development process described here is presented as an optional method (or series of steps) to consider when designing a small scale, multi-site implementation study. The process grew from an evidence-based quality improvement strategy developed for – and proven efficacious in – primary care settings. The authors are currently studying the efficacy of the process across a spectrum of specialty care treatment settings.
Literature
1.
Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O: Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q. 2004, 82: 581-630. 10.1111/j.0887-378X.2004.00325.x.CrossRefPubMedPubMedCentral
2.
Wagner EH, Glasgow RE, Davis C, Bonomi AE, Provost L, McCulloch D, Carver P, Sixta C: Quality improvement in chronic illness care: a collaborative approach. Jt Comm J Qual Improv. 2001, 27: 63-80.PubMed
3.
Rogers E: Diffusion of Innovations. 1995, New York: The Free Press, 5
4.
Hagedorn H, Hogan M, Smith JL, Bowman C, Curran GM, Espadas D, Kimmel B, Kochevar L, Legro MW, Sales AE: Lessons learned about implementing research evidence into clinical practice. Experiences from VA QUERI. J Gen Intern Med. 2006, 21 Suppl 2: S21-S24.PubMed
5.
McCormack B, Kitson A, Harvey G, Rycroft-Malone J, Titchen A, Seers K: Getting evidence into practice: the meaning of "context". J Adv Nurs. 2002, 38: 94-104. 10.1046/j.1365-2648.2002.02150.x.CrossRefPubMed
6.
Kochevar LK, Yano EM: Understanding health care organization needs and context. Beyond performance gaps. J Gen Intern Med. 2006, 21 Suppl 2: S25-S29.PubMed
7.
Sales A, Smith J, Curran G, Kochevar L: Models, strategies, and tools. Theory in implementing evidence-based findings into health care practice. J Gen Intern Med. 2006, 21 Suppl 2: S43-S49.PubMed
8.
Kiefe CI, Sales A: A state-of-the-art conference on implementing evidence in health care. Reasons and recommendations. J Gen Intern Med. 2006, 21 Suppl 2: S67-S70.PubMed
9.
Stetler CB, Legro MW, Wallace CM, Bowman C, Guihan M, Hageodorn H, Kimmel B, Sharp ND, Smith JL: The role of formative evaluation in implementation research and the QUERI experience. J Gen Intern Med. 2006, 21 Suppl 2: S1-S8.CrossRefPubMed
10.
Bartholomew LK, Parcel GS, Kok G, Gottilieb NH: Changing Behavior and Environment: How to Plan Theory- and Evidence-Based Disease Management Programs. Changing Patient Behavior: Improving Outcomes in Health and Disease Management. Jossey-Bass. Edited by: Patterson R. 2001
11.
Black K, Revere L: Sigma arises from the ashes of TQM with a twist. Int J Health Care Qual Assur Inc Leadersh Health Serv. 2006, 19: 159-66.
12.
Matchar DB, Patwardhan MB, Samsa GP, Haley WE: Facilitated process improvement: an approach to the seamless linkage between evidence and practice in CKD. Am J Kidney Dis. 2006, 47: 549-52. 10.1053/j.ajkd.2005.11.016.CrossRef
13.
Rubenstein LV, Parker LE, Meredith LS, Altschuler A, dePillis E, Hernandes J, Gordon NP: Understanding Team-based Quality Improvement for Depression in Primary Care. HSR. 2002, 37: 1009-1028.PubMedPubMedCentral
14.
Grimshaw J, Eccles M, Thomas R, MacLennan G, Ramsay C, Fraser C, Vale L: Toward evidence-based quality improvement. Evidence (and its limitations) of the effectiveness of guideline dissemination and implementation strategies 1966–1998. J Gen Intern Med. 2006, 21 Suppl 2: S14-S20.PubMed
15.
16.
17.
Curran GM, Thrush CR, Smith JL, Owen RR, Ritchie M, Chadwick D: Implementing research findings into practice using clinical opinion leaders: barriers and lessons learned. Jt Comm J Qual Patient Saf. 2005, 31: 700-7.PubMed
18.
McQueen L, Mittman BS, Demakis JG: Overview of the Veterans Health Administration (VHA) Quality Enhancement Research Initiative (QUERI). J Am Med Inform Assoc. 2004, 11: 339-343. 10.1197/jamia.M1499.CrossRefPubMedPubMedCentral
19.
Stetler C, Legro M, Rycroft-Malone J, Bowman C, Curran G, Guihan M, Hagedorn H, Pineros S, Wallace C: Role of "external facilitation" in implementation of research findings: a qualitative evaluation of facilitation experiences in the Veterans Health Administration. Implementation Science. 2006, 1: 23-10.1186/1748-5908-1-23.CrossRefPubMedPubMedCentral
20.
Stetler CB, Mittman BS, Francis J: Overview of the VA Quality Enhancement Research Initiative (QUERI) and QUERI theme articles: QUERI Series. Implementation Science. 2008, 3: 8-10.1186/1748-5908-3-8.CrossRefPubMedPubMedCentral
21.
Feussner JR, Kizer KW, Demakis JG: The Quality Enhancement Research Initiative (QUERI): from evidence to action. Med Care. 2000, 38 (6 Suppl 1): I1-6.PubMed
22.
Sussman S, Valente TW, Rohrbach LA, Skara S, Pentz MA: Translation in the health professions: converting science into action. Eval Health Prof. 2006, 29: 7-32. 10.1177/0163278705284441.CrossRefPubMed
23.
Lavis JN, Lomas J, Hamid M, Sewankambo : Assessing country-level efforts to link research to action. Bull World Health Organ. 2006, 84: 620-628. 10.2471/BLT.06.030312.CrossRefPubMedPubMedCentral
24.
Green LW, Kreuter MW, Deeds SG, Partridge KB: Health education planning model (PRECEDE). Health Education Planning: a Diagnostic Approach. Edited by: Green LW. 1980, Palo Alto, CA: Mayfield Publishing Co
25.
Woolf SH: Changing physician practice behavior. J Family Prac. 2000, 49: 126-129.
26.
Ajzen I: The theory of planned behavior. Organizational Behavior and Human Decision Processes. 1991, 50: 179-211. 10.1016/0749-5978(91)90020-T.CrossRef
27.
Bandura A: Social Learning Theory. 1977, New York: General Learning Press
28.
Jorgensen DL: Participant observation: a methodology for human studies. 2001, Thousand Oaks, CA: Sage
29.
Demakis JG, McQueen , Kizer KW, Feussner JR: Quality Enhancement Research Initiative (QUERI): A collaboration between research and clinical practice. Med Care. 2000, 38 (6 Suppl 1): I17-I25.PubMed
30.
McQueen l, Mittman BS, Demakis JGl: Overview of the Veterans Health Administration (VHA) Quality Enhancement Research Initiative (QUERI). J Am Med Inform Assoc. 2004, 11: 339-43. 10.1197/jamia.M1499.CrossRefPubMedPubMedCentral
31.
Sobo EJ: Parents' perceptions of pediatric day surgery risks: unforeseeable complications, or avoidable mistakes?. Soc Science & Med. 2005, 60: 2341-2350.CrossRef
32.
Ferguson TB: Continuous quality improvement in medicine: validation of a potential role for medical specialty societies. Am Heart Hosp J. 2003, 1: 264-72. 10.1111/j.1541-9215.2003.02502.x.CrossRefPubMed
33.
Benedetto AR: Six Sigma: not for the faint of heart. Radiol Manage. 2003, 25: 40-53.PubMed
34.
Rubenstein LR, Pugh J: Strategies for promoting organizational and practice change by advancing implementation research. J Gen Intern Med. 2006, 21 Suppl 2: S58-S64.CrossRefPubMed
35.
Wensing M, Wollersheim H, Grol R: Organizational interventions to implement improvements in patient care: a structured review of reviews. Implementation Science. 2006, 1: 2-10.1186/1748-5908-1-2.CrossRefPubMedPubMedCentral
36.
Bonneti D, Eccles M, Johnston M, Steen N, Grimshaw J, Baker R, Walker A, Pitts N: Guiding the design and selection of interventions to influence the implementation of evidence-based practice: an experimental simulation of a complex intervention trial. Soc Sci Med. 2005, 60: 2135-47. 10.1016/j.socscimed.2004.08.072.CrossRef
37.
Shadish WR, Cook TD, Campbell DT: Experimental and Quasi-Experimental Designs for Generalized Causal Inference. 2001, Boston, MA: Houghton Mifflin
38.
Patton MQ: Qualitative Research & Evaluation Methods. 2002, Thousand Oaks, CA: Sage, 3
39.
Grimshaw JM, Shittan L, Thomas R, Mowatt G, Fraser C, Bero L, Grilli R, Harvey E, Oxman A, O'Brien MA: An overview of systematic reviews of interventions. Med Care. 2001, 39: 112-145. 10.1097/00005650-200108002-00002.CrossRef
40.
Rubenstein LV, Mittman BS, Yano EM, Mulrow DC: From understanding health care provider behavior to improving health care: the QUERI framework for quality improvement. Med Care. 2000, 38 (6 Suppl 1): I129-I141.PubMed
41.
Davis DA, Taylor-Vaisey A: Translating guidelines into practice. A systematic review of theoretic concepts, practical experience and research evidence in the adoption of clinical practice guidelines. CMAJ. 1997, 157: 408-16.PubMedPubMedCentral
42.
Freemantle N, Harvey EL, Wolf F, Grimshaw JM, Grilli R, Bero LA: Printed educational materials: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2000, 2: CD000172-PubMed
43.
Eccles M, Grimshaw J, Walker A, Johnston M, Pitts N: Changing the behavior of healthcare professionals: the use of theory in promoting the uptake of research findings. J Clin Epidemiol. 2005, 58: 113-6. 10.1016/j.jclinepi.2004.10.002.CrossRef
44.
Stetler CB: Role of the organization in translating research into evidence-based practice. Outcomes Management. 2003, 7: 97-103.PubMed
45.
Glisson C, Schoenwald K: The ARC Organizational and Community Intervention Strategy for Implementing Evidence-Based Children's Mental Health Treatments. Ment Health Serv Res. 2005, 7: 243-259. 10.1007/s11020-005-7456-1.CrossRefPubMed
46.
Kravitz RL, Duan N, Braslow J: Evidence-Based Medicine, Heterogeneity of Treatment Effects, and the Trouble with Averages. The Milbank Q. 2004, 82: 661-687. 10.1111/j.0887-378X.2004.00327.x.CrossRefPubMed
Metadata
Title
A process for developing an implementation intervention: QUERI Series
Authors
Geoffrey M Curran
Snigda Mukherjee
Elise Allee
Richard R Owen
Publication date
01-12-2008
Publisher
BioMed Central
Published in
Implementation Science / Issue 1/2008
Electronic ISSN: 1748-5908
DOI
https://doi.org/10.1186/1748-5908-3-17

Other articles of this Issue 1/2008

Implementation Science 1/2008 Go to the issue

Research article

Physician attitude toward depression care interventions: Implications for implementation of quality improvement initiatives

Debate

A work force model to support the adoption of best practice care in chronic diseases – a missing piece in clinical guideline implementation

Research article

Mapping as a knowledge translation tool for Ontario Early Years Centres: views from data analysts and managers

Methodology

An organizational framework and strategic implementation for system-level change to enhance research-based practice: QUERI Series

Methodology

Overview of the VA Quality Enhancement Research Initiative (QUERI) and QUERI theme articles: QUERI Series

Research article

The intellectual structure and substance of the knowledge utilization field: A longitudinal author co-citation analysis, 1945 to 2004