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Sustainment of diverse evidence-informed practices disseminated in the Veterans Health Administration (VHA): initial development and piloting of a pragmatic survey tool.

Publication ,  Journal Article
Reardon, CM; Damschroder, L; Opra Widerquist, MA; Arasim, M; Jackson, GL; White, B; Cutrona, SL; Fix, GM; Gifford, AL; DeLaughter, K; King, HA ...
Published in: Implement Sci Commun
January 16, 2023

BACKGROUND: There are challenges associated with measuring sustainment of evidence-informed practices (EIPs). First, the terms sustainability and sustainment are often falsely conflated: sustainability assesses the likelihood of an EIP being in use in the future while sustainment assesses the extent to which an EIP is (or is not) in use. Second, grant funding often ends before sustainment can be assessed. The Veterans Health Administration (VHA) Diffusion of Excellence (DoE) program is one of few large-scale models of diffusion; it seeks to identify and disseminate practices across the VHA system. The DoE sponsors "Shark Tank" competitions, in which leaders bid on the opportunity to implement a practice with approximately 6 months of implementation support. As part of an ongoing evaluation of the DoE, we sought to develop and pilot a pragmatic survey tool to assess sustainment of DoE practices. METHODS: In June 2020, surveys were sent to 64 facilities that were part of the DoE evaluation. We began analysis by comparing alignment of quantitative and qualitative responses; some facility representatives reported in the open-text box of the survey that their practice was on a temporary hold due to COVID-19 but answered the primary outcome question differently. As a result, the team reclassified the primary outcome of these facilities to Sustained: Temporary COVID-Hold. Following this reclassification, the number and percent of facilities in each category was calculated. We used directed content analysis, guided by the Consolidated Framework for Implementation Research (CFIR), to analyze open-text box responses. RESULTS: A representative from forty-one facilities (64%) completed the survey. Among responding facilities, 29/41 sustained their practice, 1/41 partially sustained their practice, 8/41 had not sustained their practice, and 3/41 had never implemented their practice. Sustainment rates increased between Cohorts 1-4. CONCLUSIONS: The initial development and piloting of our pragmatic survey allowed us to assess sustainment of DoE practices. Planned updates to the survey will enable flexibility in assessing sustainment and its determinants at any phase after adoption. This assessment approach can flex with the longitudinal and dynamic nature of sustainment, including capturing nuances in outcomes when practices are on a temporary hold. If additional piloting illustrates the survey is useful, we plan to assess the reliability and validity of this measure for broader use in the field.

Duke Scholars

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Published In

Implement Sci Commun

DOI

EISSN

2662-2211

Publication Date

January 16, 2023

Volume

4

Issue

1

Start / End Page

6

Location

England

Related Subject Headings

  • 4206 Public health
  • 4203 Health services and systems
 

Citation

APA
Chicago
ICMJE
MLA
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Reardon, C. M., Damschroder, L., Opra Widerquist, M. A., Arasim, M., Jackson, G. L., White, B., … Nevedal, A. L. (2023). Sustainment of diverse evidence-informed practices disseminated in the Veterans Health Administration (VHA): initial development and piloting of a pragmatic survey tool. Implement Sci Commun, 4(1), 6. https://doi.org/10.1186/s43058-022-00386-z
Reardon, Caitlin M., Laura Damschroder, Marilla A. Opra Widerquist, Maria Arasim, George L. Jackson, Brandolyn White, Sarah L. Cutrona, et al. “Sustainment of diverse evidence-informed practices disseminated in the Veterans Health Administration (VHA): initial development and piloting of a pragmatic survey tool.Implement Sci Commun 4, no. 1 (January 16, 2023): 6. https://doi.org/10.1186/s43058-022-00386-z.
Reardon CM, Damschroder L, Opra Widerquist MA, Arasim M, Jackson GL, White B, et al. Sustainment of diverse evidence-informed practices disseminated in the Veterans Health Administration (VHA): initial development and piloting of a pragmatic survey tool. Implement Sci Commun. 2023 Jan 16;4(1):6.
Reardon, Caitlin M., et al. “Sustainment of diverse evidence-informed practices disseminated in the Veterans Health Administration (VHA): initial development and piloting of a pragmatic survey tool.Implement Sci Commun, vol. 4, no. 1, Jan. 2023, p. 6. Pubmed, doi:10.1186/s43058-022-00386-z.
Reardon CM, Damschroder L, Opra Widerquist MA, Arasim M, Jackson GL, White B, Cutrona SL, Fix GM, Gifford AL, DeLaughter K, King HA, Henderson B, Vega R, Nevedal AL. Sustainment of diverse evidence-informed practices disseminated in the Veterans Health Administration (VHA): initial development and piloting of a pragmatic survey tool. Implement Sci Commun. 2023 Jan 16;4(1):6.

Published In

Implement Sci Commun

DOI

EISSN

2662-2211

Publication Date

January 16, 2023

Volume

4

Issue

1

Start / End Page

6

Location

England

Related Subject Headings

  • 4206 Public health
  • 4203 Health services and systems