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262 Using stakeholder partnerships to optimize implementation of ‘coach mclungssm’, an asthma shared decision making intervention, into primary care
  1. Hazel Tapp1,
  2. Kelly Reeves1,
  3. Lindsay Shade1,
  4. Thomas Ludden1,
  5. Andrew Mcwilliams1,
  6. Lyn Nuse1,
  7. Cheryl Courtlandt1,
  8. Andrea Desantis1,
  9. Yhenneko Taylor1,
  10. Diane Derkowski1,
  11. Denise Derkowski,
  12. Jeremy Thomas1,
  13. Charity Patterson2,
  14. Kasey Boehmer3,
  15. Tekesha Jones1,
  16. Melanie Hogg1,
  17. Melissa Calvert,
  18. Beth Burton1,
  19. Jeffrey Cleveland1,
  20. Saul Amezquita1,
  21. Caroline Cox4,
  22. Nick Stevens1,
  23. Margo Burnard1,
  24. Katherine O’hare1,
  25. Lindsay Deneault1
  1. 1Department of Family Medicine, Atrium Health, Charlotte, NC USA
  2. 2School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA USA
  3. 3Knowledge and Evaluation Research (KER) Unit, Mayo Clinic, Rochester, MN USA
  4. 4Wellstar Health System, Marietta, GA USA

Abstract

Background Coach McLungsSM is an interactive web-based asthma application currently being implemented within 21 primary care practices within a large healthcare system. Our objective is to describe using implementation science frameworks to engage a stakeholder advisory board in prioritizing strategies to optimize implementation.

Methods Surveys from the Consolidated Framework for Implementation Research CFIR, and the Organizational Readiness for Implementing Change ORIC, were given to providers and staff from eight primary care practices. Survey questions were scored on a Likert scale between 1 and 5. Scores below 4 identified implementation areas of concern and prompted the selection of associated recommendations from the Expert Recommendations for Implementing Change, ERIC, framework. These ERIC Strategies were discussed and priortized at a quarterly meeting Stakeholder Advisory Board, consisting of patients, providers, advocacy organizations, and researchers.

Results There was strong readiness for change with providers committed to implement Coach McLungsSM. Providers felt Coach McLungsSM improved patients‘ knowledge about uncontrolled asthma and self management, and provided decision support for asthma management. Of concern were the willingness of leadership to discuss changes that would improve care (mean change commitment = 3.21); and provision of appropriate staffing or training (mean change commitment = 3.47 training; 3.06 staffing). These lower scoring survey results matched to 7 ERIC recommendations that were presented to stakeholders for discussion and prioritization. Based on responses from 25 stakeholders three strategies were chosen.

Discussion Chosen strategies were to identify and prepare provider champions, involve leaders in the implementation, and capture best practices from providers on working with Coach McLungsSM are currently being implemented.

Conclusion Engaging stakeholders in a discussion and prioritization process involving multiple implementation frameworks successfully identified three strategies that were fedback to practices to improve practice uptake of Coach McLungsSM, a shared decision making intervention.

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