Application of the replicating effective programs framework to design a COPD training program.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death globally and a common cause of hospital readmissions in the United States. While best practices exist in COPD management, incorporation of such approaches into routine clinical care remains a challenge. OBJECTIVES: This evaluation applied principles from the field of dissemination and implementation (D&I) science to design a training package integrating best practice for COPD management. The D&I field promotes evidence-based implementation strategies, frameworks, and assessment approaches that can be considered by clinicians to promote adoption of best practices. METHODS: This prospective mixed-methods evaluation applied a D&I science model to develop, implement, and evaluate an interprofessional training program for COPD management originally piloted in 2016. The authors provide a contextual example of how a guiding D&I framework, replicating effective programs, was applied to design and implement a Web-based training program for clinicians preparing to implement the COPD service. A questionnaire and profession-specific focus group sessions were conducted to evaluate trainee confidence and enactment of critical service components. RESULTS: A total of 41 of the 50 interprofessional trainees responded to the pre- and postquestionnaire including primary care clinical pharmacists (n = 15), primary care registered nurses (n = 9), triage registered nurses (n = 12), and respiratory therapists (n = 5). Statistically significant improvements in trainee confidence and enactment were observed in 31 of the 40 total survey items (77%). Pooled focus group data provided attestation that the training enhanced practitioners' confidence in their role within the service. Opportunities for further improvement were also identified, such as incorporating a video modeling clinic example and accompanying written materials. CONCLUSION: This evaluation provides a case-study example of how D&I science can be used to design, implement, and evaluate a training package for trainees to spread a promising best practice. Clinicians can consider similar applications of D&I science to enhance training and spread novel services across health systems.

Building capacity for dissemination and implementation to maximize research impact in a CTSA: The University of Wisconsin story.

We report results of an 8-year process of stakeholder engagement aimed at building capacity in Dissemination and Implementation (D&I) research at the University of Wisconsin as part of the National Institutes of Health's Clinical and Translational Science Award (CTSA). Starting in 2008, annual individual interviews were held with leaders of the Wisconsin CTSA's community engagement core for strategic planning purposes. Interviews were followed by annual planning meetings that employed a facilitated group decision-making process aimed at identifying and prioritizing gaps in the translational research spectrum. In 2011, the stakeholder engagement process identified D&I as a primary gap limiting overall impact of the institution's research across the translational spectrum. Since that time, our CTSA has created an array of D&I resources falling into four broad categories: (1) relationship building with D&I partners, (2) D&I skill building, (3) translational research resources, and (4) resources to support D&I activities. Our systematic process of stakeholder engagement has increased the impact of research by providing D&I resources to meet investigator and community needs. CTSAs could engage with leaders of their community engagement cores, which are common to all CTSAs, to adapt or adopt these resources to build D&I capacity.