Evidence-Based Practice Implementation in Community Mental Health Settings: The Relative Importance of Key Domains of Implementation Activity
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Implementation research has examined practice prioritization, implementation leadership, workforce development, workflow re-engineering, and practice reinforcement, but not addressed their relative importance as implementation drivers. This study investigated domains of implementation activities and correlated them to implementation success during a large national evidence-based practice implementation project. Implementation success was correlated with active leadership strategically devoted to redesigning the flow of work and reinforcing implementation through measurement and feedback. Relative attention to workforce development was negatively correlated with implementation. Active leaders should focus on redesigning the flow of work to support the implementation and on reinforcing program improvements.
KeywordsPractice implementation Severe mental illness Evidence-based practice
This research was supported by grant 036805 from the Robert Wood Johnson Foundation; contract 280-02-8070 from the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration; a gift from the West Family Foundation; and the Johnson & Johnson–Dartmouth Community Mental Health Program. The authors thank the members of the National Implementing Evidence-Based Practices Project team and the participants at the sites in the eight states.
- Atlas.ti 2.0 (2002) Atlas.ti 2.0 [Computer software]. Berlin, Germany: GmbH.Google Scholar
- Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M., & Wallace, F. (2005). Implementation research: A synthesis of the literature. Tampa, FL: University of South Florida.Google Scholar
- Forsetlund, L., Bjorndal, A., Rashidian, A., Jamtvedt, G., O’Brien, M. A., Wolf, F., et al. (2009). Continuing education meetings and workshops: Effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews (Online), 2(2), CD003030. doi: 10.1002/14651858.CD14003030.pub14651852.
- Godfrey, J. L. (2010). Re-implementing assertive community treatment: One agency’s challenge of meeting state standards. Unpublished dissertation. Indianapolis: Indiana University-Purdue University Indianapolis.Google Scholar
- Hoffman, L. R. (1979). The group problem solving process: Studies of a valence model. New York: Praeger.Google Scholar
- Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press.Google Scholar
- Jamtvedt, G., Young, J. M., Kristoffersen, D. T., O’Brien, M. A., & Oxman, A. D. (2006). Audit and feedback: Effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews (Online), 2(2). doi: 10.1002/14651858.CD14000259.pub14651852.
- Joyce, B., & Showers, B. (2002). Student achievement through staff development (3rd ed.). Alexandria, VA: Association for Supervision and Curriculum Development.Google Scholar
- McFarlane, W. R., McNary, S., Dixon, L., Hornby, H., & Cimett, E. (2001). Predictors of dissemination of family psychoeducation in community mental health centers in Maine and Illinois. Psychiatric Services, 50, 818–824.Google Scholar
- Mendel, P., Meredith, L. S., Schoenbaum, M., Sherbourne, C. D., & Wells, K. B. (2008). Interventions in organizational and community context: A framework for building evidence on dissemination and implementation in health services research. Administration and Policy in Mental Health and Mental Health Services Research, 35, 21–37.PubMedCrossRefGoogle Scholar
- New Freedom Commission on Mental Health. (2003). Achieving the promise: Transforming mental health care in America. Final Report. DHHS Pub. No. SMA-03-3832. Rockville, MD: Substance Abuse and Mental Health Services Administration.Google Scholar
- O’Brien, M. A., Rogers, S., Jamtvedt, G., Oxman, A. D., Odgaard-Jensen, J., Kristoffersen, D. T., et al. (2007). Educational outreach visits: Effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews (Online), 4(4):CD000409. doi: 10.1002/14651858.CD14000409.pub14651852.
- Proctor, E. K., Landsverk, J., Aarons, G., Chambers, D., Glisson, C., & Mittman, B. (2009). Implementation research in mental health services: An emerging science with conceptual, methodological, and training challenges. Administration and Policy in Mental Health and Mental Health Services Research, 36, 24–34.PubMedCrossRefGoogle Scholar
- Rapp, C. A., & Goscha, R. J. (2006). The strengths model: Case management with people with psychiatric diabilities (2nd ed.). New York: Oxford University Press.Google Scholar
- Rollins, A. L., Salyers, M. P., Tsai, J., & Lydick, J. M. (2010). Staff turnover in statewide implementation of ACT: Relationship with ACT fidelity and other team characteristics. Administration and Policy in Mental Health and Mental Health Services Research, 37, 417–426.PubMedCrossRefGoogle Scholar
- Schoenwald, S. K., Garland, A. F., Chapman, J. E., Frazier, S. L., Sheidow, A. J., & Southam-Gerow, M. A. (2010a). Toward the effective and efficient measurement of implementation fidelity. Administration and Policy in Mental Health and Mental Health Services Research, 37, doi: 10.1007/s10488-10010-10321-10480.
- Surgeon General. (2000). Surgeon General’s report on mental health. Washington, DC: US Government Printing Office.Google Scholar
- Thomson O’Brien, M. A., Oxman, A. D., Haynes, R. B., Davis, D. A., Freemantle, N., & Harvey, E. L. (2000). Local opinion leaders: Effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews (Online), 2(2), CD000125. doi: 10.1002/14651858.CD000125.
- Wang, M. C., Hyun, J. K., Harrison, M. I., Shortell, S. M., & Fraser, I. (2006). Redesigning health systems for quality: Lessons from emerging practices. Joint Commission Journal on Quality and Patient Safety, 11, 599–611.Google Scholar