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(BMC Neurology 19:294, 2019).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Design<\/jats:title>\n                <jats:p>A stepped-wedge implementation trial with six geographically diverse sites.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Participants<\/jats:title>\n                <jats:p>The six facility QI teams were multi-disciplinary, clinical staff.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Interventions<\/jats:title>\n                <jats:p>PREVENT employed a bundle of key implementation strategies: team activation; external facilitation; and a community of practice. This strategy bundle had direct ties to four constructs from the Consolidated Framework for Implementation Research (CFIR): Champions, Reflecting &amp; Evaluating, Planning, and Goals &amp; Feedback.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Main Measures<\/jats:title>\n                <jats:p>Using a mixed-methods approach guided by the CFIR and data matrix analyses, we evaluated the degree to which implementation success and clinical improvement were associated with implementation strategies. The primary outcomes were the number of completed implementation activities, the level of team organization and <jats:underline>&gt;<\/jats:underline>\u200915 points improvement in the Without Fail Rate (WFR) over 1\u00a0year.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Key Results<\/jats:title>\n                <jats:p>Facility QI teams actively engaged in the implementation strategies with high utilization. Facilities with the greatest implementation success were those with central champions whose teams engaged in planning and goal setting, and regularly reflected upon their quality data and evaluated their progress against their QI plan. The strong presence of effective champions acted as a pre-condition for the strong presence of Reflecting &amp; Evaluating, Goals &amp; Feedback, and Planning (rather than the other way around), helping to explain how champions at the +2 level influenced ongoing implementation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The CFIR-guided bundle of implementation strategies facilitated the local implementation of the PREVENT QI program and was associated with clinical improvement in the national VA healthcare system.<\/jats:p>\n                <jats:p>Trial registration: clinicaltrials.gov: NCT02769338<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11606-020-06100-w","type":"journal-article","created":{"date-parts":[[2020,11,4]],"date-time":"2020-11-04T00:05:03Z","timestamp":1604448303000},"page":"322-332","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Implementation Evaluation of a Complex Intervention to Improve Timeliness of Care for Veterans with Transient Ischemic Attack"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6544-2577","authenticated-orcid":false,"given":"T. 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The funding agencies had no role in the design of the study, data collection, analysis, interpretation, or in the writing of this manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclaimer"}},{"value":"PREVENT and the Implementation Evaluation team received human subjects (institutional review board [IRB]) and VA research and development committee approvals. Staff members who participated in interviews provided verbal informed consent. PREVENT was registered with clinicaltrials.gov (NCT02769338) and received human subjects (institutional review board [IRB]) and VA research and development committee approvals. In addition, the implementation evaluation received separate human subjects (IRB) and VA research and development committee approvals (IRB 1602800879).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval and Consent to Participate"}},{"value":"This manuscript does not include any individual person\u2019s data.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Publish"}},{"value":"The authors declare that they have no competing interests. TD, AP, LM: Disclosed funding from a VA HSRD QUERI grant. DMB, EJM, NR, LP, BH, JM, AJC, SB, CA, JJS, ZY, LDM, BG, and MK reported no conflicts of interest.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}}]}}