Adapting the Consolidated Framework for Implementation Research to Create Organizational Readiness and Implementation Tools for Project ECHO

Journal of Continuing Education in the Health Professions (Quarter 1, 2018) Serhal, Eva; Arena, Amanda; Sockalingam, Sanjeev

Researchers at the University of New Mexico developed Project ECHO (Extension for Community Healthcare Outcomes) to enhance access to and quality of hepatitis C care across the state. Project ECHO relies on a "hub" and "spoke" approach to encourage knowledge exchange between health care specialists typically located at academic centers (who serve as the hub) and primary care providers (PCPs) at the front line of community healthcare (who comprise the spokes). PCPs can link with specialists and other PCPs practicing in similar settings via multipoint video technology to discuss best practices and complex cases. The platform features a lecture delivered by a member of the hub team, based on curriculum developed from guidelines, best practices and/or a needs assessment, in addition to recommendations for case management (telementoring) offered by the community in response to anonymized clinical cases presented by spoke sites. When ECHO Ontario Mental Health (ECHO-ONMH) sought to create a readiness tool for the implementation of ECHO, it adapted and integrated Damschroder's (2009) Consolidated Framework for Implementation Research (CFIR) framework, which integrates 19 different well-known implementation models. A comprehensive list of Damschroder's CFIR Constructs (intervention characteristics, internal and external settings, characteristics of individuals and processes) and their associated descriptions were reviewed and discussed by the ECHO-ONMH team, who were well-versed in the ECHO implementation process. Then, ECHO-related tasks were mapped onto each CFIR construct and subconstructs, creating a third column of ECHO-specific implementation constructs and linking the ECHO practical steps with CFIR theoretical considerations.

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