Imagine that you are charged with implementing a new service for your patients. One of your top priorities is ensuring the service is delivered in a way that all of your patients can fully benefit. To optimize its impact, you would first need to ensure that this service is implemented with both consistency and quality. Not only would you need to think through your implementation strategy, but you also need to consider how to measure and monitor implementation success to understand your implementation progress and make the necessary adjustments. One way to monitor your implementation success is by assessing relevant implementation outcomes.
Implementation outcomes have been defined as the, “effects of deliberate and purposive action to implement new treatments, practices, and services.”1 They include outcomes such as: adoption, acceptability, feasibility, appropriateness, penetration, sustainability, fidelity, and cost.1 As pre-conditions for achieving the desired clinical outcomes, they can serve as indicators of progress and success when implementing a service (e.g., How is the implementation progressing? What needs to be improved? Was the implementation successful?). Implementation outcomes have been widely incorporated as implementation effectiveness indicators in other disciplines (such as public health and education). However, their use in pharmacy practice and research is just starting to emerge.
Through the ACCP CMM in Primary Care Study,2 a new Implementation Outcomes Questionnaire (IOQ) was developed and validated, specifically for use in pharmacy practice. This self-report questionnaire includes measures for adoption, acceptability, feasibility, appropriateness, penetration, and sustainability. The measures are designed to be used together or separately, depending on the purpose of the assessment and on the stage of service implementation. An accompanying practical and user-friendly scoring rubric has been developed to guide scoring and interpretation of results.
The IOQ has now been used in a diverse set of projects to measure implementation of services such as Comprehensive Medication Management (CMM) and Medication Therapy Management (MTM). In addition, the tool has been used in different practice settings such as ambulatory care, specialty pharmacy, and telepharmacy. Additional upcoming projects aim to utilize and tailor this tool with pharmacist-led behavioral health, cardiovascular disease, diabetes, and HIV medication management services in community pharmacy.
The IOQ is now available for pharmacists, pharmacy managers, pharmacy researchers, and others to gain insights into their implementation efforts. The questionnaire results should be used to understand implementation progress and success, and facilitate decision-making with any necessary mid-implementation corrections. Ultimately, an evidence-based intervention that is implemented with quality should increase the likelihood of achieving consistent clinical outcomes.
Check out the full article Measuring implementation of medication optimization services: Development and validation of an implementation outcomes questionnaire to learn more about how the IOQ was developed and validated. Access the full IOQ and IOQ scoring rubric to use in your own future work and meet your service implementation needs. All questions about this novel questionnaire can be directed to Melanie Livet, PhD, Implementation Scientist, at melanie.livet@unc.edu.
References:
- Proctor E, Silmere H, Raghavan R, et al. Outcomes for implementation research: Conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Heal Ment Heal Serv Res. 2011;38(2):65-76. doi:10.1007/s10488-010-0319-7
- American College of Clinical Pharmacy. ACCP Report (September).; 2017. https://www.accp.com/docs/report/0917.pdf. Accessed November 3, 2017.