Using a “Kickoff” to build implementation partner teams and action plans for active implementation of a quality improvement project

TL;DR

This paper describes how a kickoff event helped teams prepare for a quality improvement project in stroke care at VA hospitals.

Contribution

The paper introduces a structured kickoff strategy based on multiple frameworks to support successful implementation of quality improvement initiatives.

Findings

Interactive and interpersonal design elements were perceived as useful for forming teams and action plans.

In-person and hybrid setups helped emphasize the quality problem and motivate providers to improve stroke/TIA care.

Kickoffs during pre-implementation effectively engage clinical teams and support practice changes.

Abstract

A strategy for transitioning implementation successfully from pre-implementation to active implementation is to hold a team “kickoff.” The objectives of this manuscript are: (1) to present the frameworks that guided the development of the Protocol-guided Rapid Evaluation of Veterans Experiencing New Transient neurological symptoms (PREVENT) kickoff strategy, (2) describe design elements of the kickoff and how they contribute to achieving PREVENT kickoff aims; forming teams, developing an action plan, and launching active implementation (3) examine the perceived usefulness of those kickoff design elements toward achieving kickoff aims.

PREVENT was a stepped-wedge trial to improve the quality of Transient Ischemic Attack (TIA) care at six Veterans Affairs (VA) medical centers. The PREVENT kickoff was designed from multiple frameworks: theory of change principles for process improvement; Consolidated Framework for Implementation Research (CFIR); social learning models; and systems redesign. Data collected included pre-kickoff planning documents and post-kickoff debriefs from the PREVENT national team, Audience Response System (ARS) data, post-kickoff site participant evaluations and semi-structured interviews.

Site team participants reflected positively on the framework driven, interactive and interpersonal design elements, team building, and action plan exercises, and found them useful for a successful project launch. In-person and hybrid set-up of the kickoff, interactive elements, and team formation activities emphasized the quality problem, and motivated site implementation providers to plan for stroke/TIA care improvement.

Implementation team kickoffs during pre-implementation are a useful approach to inform and engage local clinical teams and to form plans for practice changes to improve clinical care.

clinicaltrials.gov, identifier NCT02769338.

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