Center for Care Delivery and Outcomes Research
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), 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 protocol for her current implementation project was published in Addiction Science & Clinical Practice (Hagedorn H, Kenny M, Gordon AJ, Ackland PE, Noorbaloochi S, Yu W, Harris AHS. (2018). Advancing pharmacological treatments for opioid use disorder (ADAPT-OUD): Protocol for testing a novel strategy to improve implementation of medication-assisted treatment for Veterans with opioid use disorders in low-performing facilities. Addiction Science & Clinical Practice. 13:25.). 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.
• Dr. Ackland serves 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. She brings her experience in external facilitation to two national initiatives—the Office of Mental Health and Suicide Prevention’s Stepped-Care for Opioid Use Disorder Train-the-Trainer (SCOUTT) initiative and the QUERI-VISN Partnered Implementation Initiative to improve suicide prevention through an intervention called Caring Contacts.