Developing a toolkit to implement the Statin Choice Conversation Aid at scale: application of a work reduction model

Area of Science:

• Implementation Science
• Health Services Research
• Clinical Decision Making

Background:

• Shared decision making (SDM) is recommended for statin use in cardiovascular risk management.
• A Statin Choice Conversation Aid (SCCA) tool aims to facilitate SDM.
• Developing a toolkit is crucial for the cross-organizational spread and scale of the SCCA.

Purpose of the Study:

• To develop a toolkit for scaling the SCCA intervention.
• To assess the work required by stakeholders for SCCA implementation.
• To orient toolkit components to support and mitigate implementation work.

Main Methods:

• Multi-level, mixed-methods study across 3 health systems.
• Characterization of implementation contexts using surveys, interviews, observation, and focus groups.
• Application of Normalization Process Theory to categorize stakeholder work and assess SCCA usage over time.

Main Results:

• Health systems varied in implementation feasibility, acceptability, and appropriateness.
• Strategic allocation of implementation work correlated with higher SCCA uptake.
• The developed toolkit includes self-assessments, webinars, EMR guides, and an implementation manual.

Conclusions:

• A multi-component toolkit was developed to facilitate the scale-up of SDM tools like SCCA.
• A theory-based approach identified systems ready for adoption and supported necessary implementation work.
• This approach can guide the development of toolkits for efficient intervention scale-up.