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This summary is machine-generated.

Implementation dose, or the effort to implement evidence-based practices (EBPs), varied most by the specific EBP. The type of EBP was the strongest predictor of implementation dose, not site or experience.

Keywords:
Implementation doseImplementation trackingMethods

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Area of Science:

  • Implementation Science
  • Healthcare Management
  • Health Services Research

Background:

  • Measuring implementation effort for evidence-based practices (EBPs) is crucial in implementation science.
  • Existing methods may not be pragmatic or prospective enough for real-world trials.
  • This study addresses the need for practical measurement of implementation activities and dose.

Purpose of the Study:

  • To demonstrate prospective and pragmatic documentation of implementation activities in a real-world trial.
  • To quantify implementation dose (frequency and time) across four different EBPs.
  • To explore factors influencing variations in implementation dose.

Main Methods:

  • A prospective, pragmatic tracking system was developed for a type III hybrid effectiveness-implementation stepped wedge trial.
  • Implementation dose was quantified as total time spent and synchronous time (direct interaction with local implementers).
  • Multiple linear regression analyzed factors influencing implementation dose, including EBP, wave, site, and implementation progress.

Main Results:

  • Over 1,271 hours of implementation activities were captured across 25 instances of four EBPs (Surgical Pause, TAP, CAPABLE, EMPOWER) at seven VA medical centers.
  • Asynchronous administrative tasks were most frequent, followed by synchronous activities like collaborator engagement and problem-solving.
  • The specific Evidence-Based Practice (EBP) implemented was the primary driver of variation in implementation dose.

Conclusions:

  • The type of Evidence-Based Practice (EBP) is a significantly stronger predictor of required implementation dose than other factors.
  • Site characteristics and implementer experience did not independently explain variations in implementation dose.
  • This highlights the importance of considering EBP-specific resource needs in implementation planning.