Table 2 |
|
QUERI phases of implementation projects/QUERI pipeline |
| Phase 1: Pilot project to develop/refine an improvement/implementation program and assess
basic feasibility: |
| ◆ Small scale study within a single clinic or facility |
| ◆ Used with a substantiated clinical or delivery best practice |
| ◆ Identifies potential issues relative to routine integration of best practice such
as acceptability of the recommendation, process barriers, and needed toolkit elements |
| Phase 2: Small clinical trials to further refine and evaluate an improvement/implementation
program |
| ◆ Relatively modest but multi-site evaluation (e.g., 4-6 facilities within one or
two VA regions) |
| ◆ Conducted within a formal research and evaluation framework, e.g., an experimental
design. Usually is a hybrid design, i.e., a traditional intervention design plus a
descriptive formative evaluation [9] |
| ◆ Requires active research team support and involvement, plus modest real-time refinements
to maximize the likelihood of success and to study the process for replication requirements |
| ◆ Enables refinement before larger-scale implementation |
| Phase 3: "Regional roll-out" projects |
| ◆ Test of large-scale adoption program prior to full VA implementation with 10-20
facilities in 3-5 VA regions |
| ◆ Decreased research team support at local sites and greater involvement of stakeholders,
both nationally and locally |
| ◆ Should require less need for real-time refinements of the implementation strategy |
| ◆ Preparation for hand-off at national level |
| Phase 4: "National roll-out" effort |
| ◆ Implementation of a tested, refined strategy throughout the VA |
| ◆ Existing operations or designated leadership entity deliver the program |
| ◆ Research team support as determined per Phase 3 evaluation |
| ◆ Concurrent and ongoing evaluation, per methodology determined/refined in Phase 3 |
|
|
|
Stetler et al. Implementation Science 2008 3:8 doi:10.1186/1748-5908-3-8 |
