Category: Federal Forum Posters
Purpose: To assess if the Replicating Effective Programs model, a specific dissemination and implementation framework, serves as an appropriate model for expansion of an interprofessional transitions care service for Chronic Obstructive Pulmonary Disease (COPD) management within the Veteran population.
Dissemination and implementation science is defined by the National Institutes of Health as the expansion of effective interventions within clinical practice. At the William S. Middleton Memorial Veterans Hospital, a specific dissemination and implementation science framework, Replicating Effective Programs, was applied to facilitate expansion of an interprofessional COPD service, beginning with design and assessment of training delivered to an interprofessional healthcare team.
Methods: A training program consisting of nine audiovisual training modules was developed from October through December 2017 to provide service-specific training to an interprofessional team of healthcare practitioners. Collaborating with the leadership of a primary care provider, the training program was disseminated in January 2018 to four groups of healthcare professionals including pharmacists (n=15), nurse care managers (n=12), triage nurses (n=18), and respiratory therapists (n=5). Outcomes of the dissemination and implementation process included (1) healthcare practitioners’ perception of the training as well as (2) practitioners’ confidence in their abilities to enact service requirements after training completion. Objectives were measured using quantitative and qualitative assessment questions with data collected in April 2018 through survey distribution and profession-specific focus groups. Quantitative assessment questions were developed for each group of healthcare professionals to assess for changes in mean self-efficacy rankings pre and post-training using the Wilcoxon-signed rank test. Focus group data were recorded, transcribed, and evaluated using NVivo-QSR InternationalTM by two individuals without affiliation to the Department of Veterans Affairs.
Results: Pooled focus group data provided attestation that the training enhanced practitioners’ confidence in their role within the service, streamlined interprofessional coordination, and encouraged collaboration between professionals. Opportunities for further improvement were also identified, such as incorporation of a video modeling clinic example and accompanying written materials. Quantitative survey results were obtained from 41 interprofessional trainees, including pharmacists (n=15), nurse care managers (n=9), triage nurses (n=12), and respiratory therapists (n=5). Statistically significant improvements in trainee self-efficacy were observed in 30 of the 40 survey items (75%), with pooled focus group data supporting an improvement in trainees’ conviction to enact core elements of the service.
Conclusion: Dissemination and implementation science can be used as a model to train interprofessional teams within the Department of Veterans Affairs to deliver coordinated, comprehensive care for COPD management. This evaluation provides further reference for healthcare professionals seeking to utilize dissemination and implementation science processes to implement effective interprofessional services.
Molly Lehmann– Clinical Pharmacist Resident (Ambulatory Care), William S. Middleton Memorial Veterans Hospital, Oconomowoc, WI