Effective implementation of evidence-based interventions is a persistent challenge across community settings.Organizational readinessor, the motivation and collective capacity of an entity to adopt and sustain an innovationis important to facilitate implementation. Drawing on the

Background Readiness is an essential precursor of successful implementation; however, its conceptualization and application has proved elusive. R = MC 2 operationalizes readiness for use in practice. The purpose of this study was to (1) describe the application of R = MC 2 to assess and build readiness in nine healthcare sites responsible for implementing medication management services and (2) gain insights into the sites’ experience. Methods This mixed methods exploratory study used data collected as part of a process evaluation. Understanding application of the readiness process (Aim 1) involved examining team members’ involvement (who?), readiness challenges and readiness building strategies (what?), strategy execution (how much?), and resulting changes (for what purpose?). To understand the sites’ experience with the R = MC 2 system (Aim 2), interviews were conducted with six of the sites to identify facilitators, barriers, and lessons learned. Data sources included a document review (e.g., sites’ action plans), survey results, and interview data. Results Sites included primary care and specialty clinics, pharmacies within health systems, and community pharmacies. Teams consisted of 4–11 members, including a lead pharmacist. The teams’ readiness activities clustered into five broad categories of readiness building strategies (e.g., building the operational infrastructure for service integration). Of the 34 strategies identified across sites, 68% were still in progress after 4 months. Engaging in the readiness process resulted in a number of outputs (e.g., data management systems) and benefits (e.g., an opportunity to ensure alignment of priorities and fit of the intervention). Based on the interviews, facilitators of the readiness process included assistance from a coach, internal support, and access to the readiness tools. Competing priorities and lack of resources, timely decision-making, and the timing of the readiness process were cited as barriers. The importance of service fit, stakeholder engagement, access to a structured approach, and rightsizing the readiness process emerged as lessons learned. Conclusions These findings provide valuable insights into the application of a readiness process. If readiness is to be integrated into routine practice as part of any implementation effort, it is critical to gain a better understanding of its application and value.

This pilot study explored provider use of an online system, Centervention, to support the delivery of empirically supported school-based mental health interventions (ESIs); and associations between components of this system [resources, training, technical assistance (TA), feedback loops], implementation indicators, and student outcomes. Multilevel modeling data were collected from 39 providers implementing ESIs with 758 students. Training, TA, and progress monitoring predicted ESI adherence, and perceived value of resources and TA influenced student responsiveness. Greater adherence was predictive of better socio-emotional outcomes. Interviews with 15 providers illuminated how they used these four Centervention support strategies. Implications for digital implementation support research are discussed.

Background: Pharmacists' interventions, particularly in the primary care setting, have demonstrated positive outcomes on patient care, but rarely translate into impact and scale when reviewed systematically. Specifically, comprehensive medication management (CMM) is often poorly understood, not well defined, and lacks a measure of fidelity. A consistent approach to delivery of CMM is critical to ensure impact. One way to achieve this is to establish the usability of an intervention, so practitioners have a common language around implementation of CMM to ensure fidelity and facilitate positive outcomes on patient care. Objective(s):The goal of this study was to establish a common language for the CMM patient care process.Methods: This study applies an established implementation science methodology and the Usable Innovation Framework to define and operationalize CMM through a network of 40 diverse primary care practices across the United States. This approach to the development of a CMM patient care process common language document included three phases: (a) Review and synthesis of the literature, (b) Vetting and consensus building, and (c) Usability testing. Results:The end product is the CMM patient care process-a common language document that describes both the five essential functions (ie, core components that must be present to carry out CMM) as well as operational definitions (ie, specific steps, activities, or tasks that must be carried out to achieve each essential function).Conclusions: Establishing a common language for the CMM patient care process ensures consistency in delivery of CMM and establishes a set of expectations across key stakeholder groups including patients, pharmacists, physicians, other health care providers, and payers. This research provides a framework and a common set of essential functions and operational definitions to guide the implementation of CMM delivery in primary care and facilitate replication, scale, and positive impact.

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