The Process of Implementing Evidence in Practice
4). Preparing for and commencing implementation
Once you have identified an evidence-practice-gap (step 1) and collected baseline data, planned for change (step 2) and identified the barriers and enablers (step 3), it is time to begin implementation. Tasks that need to be considered at this stage include delivery of training sessions, educational materials, reminders to clinicians and so forth.
Kramer and Burns (2008) described the training, supervision, and telephone reminders provided to staff. A formative evaluation was used, with input from managers and clinicians to guide the implementation process as it unfolded. They also identified a preference for a one-day training followed by monthly supervision of participating clinicians. They needed approval for staff to deliver a brief nine-session CBT intervention that combined psychosocial intervention, medication monitoring and motivational interviewing. They needed tools to screen depressed young people. And they needed staff time so that screening and necessary paperwork could be completed.
Clinic managers identified a psychologist in each clinic who was not participating in the intervention and was allocated $5,000 in salary support from the research team to monitor enrolment and screening of adolescents, collect information completed by adolescents, identify recruitment problems, communicate study concerns to the research team, facilitate audio taping and medical record review, and organise supervision sessions.
Each aspect of the process needs to be carefully prepared so that implementation runs smoothly.