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Center for Care Delivery and Outcomes Research


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Implementation Core

Purpose: The purpose of the CCDOR Implementation Core is to enhance CCDOR’s capacity to conduct rigorous and impactful implementation research by providing ongoing training and consultation in implementation theory and methods to CCDOR Investigators and staff.

Services provided: The Implementation Core meets monthly to develop general resources and training opportunities for CCDOR staff, and to provide tailored consultation to individual investigators on the development and execution of specific implementation projects.  The Implementation Core reviews and provides assistance in refining the implementation plans for research proposals submitted by CCDOR Investigators to HSR&D and provides ongoing mentoring in implementation methods for VA HSR&D Career Development Awardees. To date the Core has conducted 3 training workshops, consulted on more than 15 projects, hosted two visiting scholars, and mentored several CDAs. Tools developed by the Core (including reading and training lists and a monthly journal club) are used by junior implementation scientists around the country.

Expertise: Chaired by Hildi Hagedorn, PhD (CCDOR Core Investigator and Associate Professor Department of Psychiatry, University of Minnesota) and Princess Ackland, PhD (CCDOR Core Investigator and Assistant Professor Department of Medicine, University of Minnesota), the Implementation Core draws on the expertise of three experienced implementation scientists, including two prior QUERI Implementation Research Coordinators (Princess Ackland, PhD LP, MSPH and Hildi Hagedorn, PhD) and one prior QUERI Associate Director (Shannon Kehle-Forbes, PhD). Collectively these Core members have 40 years of experience in quality improvement, program evaluation, and implementation science, and, with their varied backgrounds in clinical psychology, behavioral epidemiology, public health, and population science, they bring a rich, interdisciplinary perspective to the training and consulting services they provide.  They have considerable experience successfully collaborating with partners in various branches of VA Operations. The breadth of expertise within the Implementation Core includes:

• Implementation Intervention design
• Hybrid, pragmatic clinical trials
• Survey, qualitative and mix methods
• Implementation Facilitation
• Formative, process, and summative evaluation design
• Integrating process evaluation into randomized controlled trials
• Implementation and sustainability planning and evaluation
    • Shared decision making
    • Patient education and communication
    • Provider behavior change
    • Behavioral, decision and implementation theories
    • Evidence-based interventions

    • Dr. Hagedorn’s main outcome paper from her most recent implementation project received recognition as a Quality Improvement and Implementation Science in Health Care Systems Top-Rated Manuscript from JGIM for 2021-2022 (Hagedorn HJ, Gustavson AM, Ackland PE, Bangerter A, Bounthavong M, Clothier B, Harris AHS, Kenny ME, Noorbaloochi S, Salameh HA, Gordon AJ. (2022). Advancing pharmacological treatments for opioid use disorder (ADAPT-OUD): An implementation trial in eight Veterans Health Administration facilities. JGIM. 37(14): 3594-602.). The external facilitation implementation strategy used in this project informed the facilitation strategy being utilized in the national Office of Mental Health and Suicide Prevention’s Stepped-Care for Opioid Use Disorder Train-the-Trainer (SCOUTT) initiative which has rolled out to at least 2 facilities in every VISN.
    •Drs. Kehle-Forbes, Hagedorn and Ackland are leading an evaluation of stakeholder engagement during the COVID-19 pandemic through a PCORI award for the Comparative Effectiveness of Trauma-focused and Non-trauma-focused Treatment Strategies for PTSD Among Those with Co-occurring SUD (COMPASS) study. Specifically, the evaluation will examine 1) adjustments made to the stakeholder engagement approach as a result of COVID-19 and how were these adjustments viewed by the study’s stakeholder panel members, 2) aspects of the adjusted approach that member choose to retain as the pandemic evolves, and 3) the ways in which members assisted in adjusting the study design and conduct to accommodate COVID-19 restrictions and the impact on the study.
    Drs. Hagedorn and Ackland serve on the leadership team for the national Implementation Facilitation Learning Collaborative—a forum for collective efforts and discussion to advance the field of implementation facilitation. They bring their experience in external facilitation from several national initiatives and projects