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Implementation Committee: May 27, 2020

In attendance: Laura, Dayna, Al, Charlotte, Jeff, Lauren, Mary, Sandy, Janet, Alexia, Sarah

Action Items:

  • Review and provide feedback on the fidelity core components document– Everyone


ECHO over the summer

  • We are now moving back to maintaining the ECHO format over the summer and will not be doing post-training intervention specific calls

  • They will take place twice a month, the first and third Thursdays of the month

  • The format has changed, the didactics will be briefer and specific to what sites want to talk about

  • They will address specific questions, challenges, basically whatever clinicians request, which is in line with the feedback we received around ECHO sessions

  • The sites will not have to present full cases, they can ask a question about a patient or about material from NAVIGATE

  • There will also be more time for questions and discussion

  • The first session starts next week

  • The working group working on creating the sessions includes Abanti, Sanjeev, and Nikki

  • We will transition back to the full curriculum in September

  • The online collaborative space will be put on hold for now, so we don’t launch too many things at the same time

  • We will still populate and create this space

Baseline Readiness Data from the first 3 sites from March 2019

  • Heather took the lead on the analyses of the data

  • Used the readiness monitoring tool, tailored to work with NAVIGATE

  • 7 point Likert scale, and also includes contextual info

  • Based on the fact that readiness is a dynamic process

  • Originally designed to be administered at 3 time points

  • Wanted it to be administered before training

  • Administered in March 2019 for the first wave (3 sites), just after in-person training

  • Good response rate

  • We want to get these results back sooner in the future

  • Across all of the sites there was overall high readiness, but less readiness in terms of motivation

  • Strong readiness in terms of general items that speak to a sense of belonging and purpose to the organization

  • The lowest rating is related to financial plans, as the staff likely don’t have access to this information

  • The ratings show adequate support and values

  • The staff say that they don’t have lots of communication from other organizations

  • The ratings for the question “We are receiving the proper training” were slightly lower – something to note

  • It’s difficult to implement the NAVIGATE model of care, this answer speaks to the complexity

  • Do sites still have concerns with motivation to implement the model of care?

  • As with most change, there was a general resistance at the beginning

  • Sometimes there can be a honeymoon period in interventions where the scores go higher, then go back down

  • Interesting to see how new sites view the training/model

  • If we don’t see positive changes from the first round of training, we want to know why

  • From now on we can get share results sooner, as we are more able to do that now

  • Planning to do this 3 times over the course of the study

  • It’s hard to get responses to surveys from clinicians, as there are already lots of asks in the project

Feedback on the Core Components document

  • It will be useful to hear feedback from implementation folks, especially how to communicate these results and engage sites on items where there is less readiness

  • We are interested in differences related to training

  • We will also include this when we go back to sites with fidelity data

  • Al says he can see him using the core components document down the road, can start to look where things are going, want to see how attitudes have shifted as there is more acceptance

  • Dayna said it could be useful, but thinks the fidelity tool is more effective

  • This was presented at steering committee today

  • There was interest in Melanie’s work, and a good discussion about who she should interview

  • We are going to send this to the US trainers to get feedback

  • Want feedback on what the core components of NAVIGATE are in the eyes of the trainers

  • It was mentioned that this should have been done before the project started

  • The ISs will review it as well

  • Want to move it forward as soon as possible

  • Helpful for clinicians to know about this, and useful for when the model of care scales up

  • Dayna used it to explain the model of care to a doctor on the project

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