Table 7 Implementation strategies and tailoring by site

A.1. Develop stakeholder buy-in

-Use of champions

ED staff, RNs (especially nursing administrators), department heads, physicians as champions

Dedicated ED faculty as champions

-Consensus discussions

Include experienced nurses; highlight GUIDED-HF’s alignment with larger HF readmission reduction initiative

Include medical director, nursing leadership, specialists, primary care; focus on understanding potential sources of provider resistance; in-person only

A.2. Marketing

Use visuals; use study fliers; workstation prompts; newsletter piece

At ED faculty and operations meetings; put executive summary in EPIC; workstation prompts; newsletter, and swag with study logo

B. CATEGORY: Educate

B.1. Conduct educational meetings

Use “train the trainer” model; host during staff meetings and nurse huddles

Repeat educational meetings every 4–6 months because of staff turnover; host during ED faculty and operations meetings; include ancillary staff in education

B.2. Develop and distribute educational material

Use in-person, not email/printed materials/computer modules

Use in-person and email distribution strategy

C. CATEGORY: Quality Management

Adapting workflow processes

Use BPA; design BPA with “opt-in” approach

Use BPA; design BPA with “opt-out” approach

D. CATEGORY: Restructuring

Audit and feedback

Provide feedback data in aggregate and at the individual level

Focus on positive rather than negative feedback and clinical outcomes; provide data in aggregate for ED providers