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TRiPLaB

TRiPLaB. NIHR LYBRA CLAHRC Board meeting Carl Thompson (Theme PI) Erica Warren (Project Lead). TRiPLaB: who’s who. Clinical audit & effectiveness team. NHS Leeds. ???. ???. Bradford DCT. Clinical audit & effectiveness team. from “why” to “how” in implementation.

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TRiPLaB

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  1. TRiPLaB NIHR LYBRA CLAHRC Board meeting Carl Thompson (Theme PI) Erica Warren (Project Lead)

  2. TRiPLaB: who’s who Clinical audit & effectiveness team NHS Leeds ??? ??? Bradford DCT Clinical audit & effectiveness team

  3. from “why” to “how” in implementation • No magic bullets (honest!) – effort needs evaluation • Can’t leave it to NICE (HSC) • Self report is not enough • macro health economies, • meso (organisations), • & micro (professionals) • all matter (Audit Commission) Source: Clinical Evidence, BMJ Publishing

  4. Develop Implement Evaluate • Describing and predicting importance (Conjoint Modelling) (Ryan 2004) • Innovation characteristics “scored” by experts • Clinician and Manager importance modelled ∆i = βCPD x βlocal prevalence x βcost effectiveness… βk BMJ 2000;320:1530-1533

  5. Develop Implement Evaluate • Producing a contextual “map” • stakeholder analysis (barriers, politics, potential innov.) • Surveying • Organisational (team) culture • Attitudes to innovation • Communication channels (Social network analysis, geo plotting)

  6. Develop IMplement Evaluate • Strategy tailored to context • Systematic theoretically informed targeting e.g. Ajzen I. Organ Behav Hum Decis Process. 1991;50:179-211

  7. Develop ImplementEvaluate • Interrupted time series analysis • pre and post intervention comparison (MLM) • qualitative process evaluation of why the intervention worked (or did not work)

  8. The work (so far) • Maternal and child health in Bradford (increasing mental health screening quantity, quality and impact*) – 6000 new mums per year • Mental health NICE guidance implementation (schizophrenia) • Stroke care in Bradford • … *with LYBRA CLAHRC child and maternal health theme

  9. achievements already • Partnership: academic - (CRD, health sciences, management) • Partnership: NHS - establishing networks and infrastructure to deliver the programme • Capacity (LPFT and BDCT) • First publications and ‘spin offs’ imminent • Research governance and the NHS research ‘maze’ negotiations progressing

  10. TRiPLaB infrastructure

  11. challenges • Multi-site working across large, complex organisations • Human resource capacity • Scientific vs. service delivery expectation • (scientific) standardisation of process should meet service delivery expectations • Funding for change techniques (e.g. SHA money for training as part of TRiPLaB change strategies).

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