Clinical trial NCT06011759: Maintaining Implementation Through Dynamic Adaptations (MIDAS) Suicide Prevention 2.0 Clinical Telehealth
Official title: Maintaining Implementation Through Dynamic Adaptations (MIDAS) - Suicide Prevention 2.0 Clinical Telehealth (SP 2.0) (QUE 20-025)
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Suicidal Self-directed Violence
Suicidal Preparatory Behavior
Keywords: implementation science
implementation strategy
suicide prevention
academic detailing
quality improvement
Lead sponsor: VA Office of Research and Development
Sponsor class: FED
First posted: 2023-08-25
Enrollment: 4
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: A multi-faceted implementation intervention including qualitative interviews and feedback and optional delivery of Academic Detailing and/or LEAP.
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: Scientific advances are constantly leading to better treatments. However, it is quite challenging for healthcare systems, including VA, to ask very busy providers to change the way they practice. The MIDAS QUERI program helps providers improve the way they treat VA patients. This project will focus on increasing referrals to the Suicide Prevention 2.0 Clinical Telehealth (SP 2.0) initiative through the delivery of Academic Detailing and LEAP (a team-based quality improvement program). SP 2.0 provides accessible, evidence-based suicide prevention treatment to all Veterans with a history of suicidal self-directed violence or preparatory behaviors in the past 12 months.

Detailed description: Sustained integration of evidence-based practices (EBPs) is a challenge within many healthcare systems, especially in settings that have already strived but failed to achieve longer-term goals. The Veterans Affairs (VA) Maintaining Implementation through Dynamic Adaptations (MIDAS) Quality Enhancement Research Initiative (QUERI) program was funded as a series of trials to test multi-component implementation strategies to sustain optimal use of EBPs. The current project focuses on increasing referrals to the Suicide Prevention 2.0 Clinical Telehealth (SP 2.0) initiative.

The investigators have recruited 4 sites for this non-randomized intervention project. Sites have agreed to participate in pre-implementation interviews to gather information regarding barriers and facilitators to use of the SP 2.0 initiative. Sites will then be provided with tailored feedback regarding interview findings and potential use of Academic Detailing and LEAP to address these. Sites may then select to receive either Academic Detailing and/or LEAP which will be provided by MIDAS QUERI. Primary outcome will be rate of SP 2.0 referral adjusted for pre-intervention rate.

Eligibility criteria: Inclusion Criteria:

Note- the investigators are recruiting clinics/medical centers - not individual patients. Prior to implementation, the investigators will work with sites to ensure they have met the preconditions necessary to begin sustained optimization of the EBP:

* 1) a team leader or champion
* 2) an identified department with service leadership buy-in and control over the processes/practices impacted by the implementation
* 3) readily accessible data to measure process and impact of the implementation and use of the EBP
* 4) availability of required resources

Exclusion Criteria:

* N/A

Primary outcomes:
measure: SP2Clin metric
timeFrame: Baseline to 12-months post-baseline
Secondary outcomes:
measure: Referral to SP 2.0 Clinic
timeFrame: Baseline to 12-months post-baseline
Other outcomes:
measure: Change in quality improvement skills application
timeFrame: Baseline to 12-months post-baseline
measure: Change in provider satisfaction with academic detailing
timeFrame: Baseline to 12-months post-baseline
measure: Change in provider satisfaction with LEAP
timeFrame: Baseline to 12-months post-baseline
Locations:
city: Ann Arbor
country: United States
facility: VA Ann Arbor Healthcare System, Ann Arbor, MI
state: Michigan
Study officials:
affiliation: VA Ann Arbor Healthcare System, Ann Arbor, MI
name: Paul N Pfeiffer, MD MS
role: PRINCIPAL_INVESTIGATOR
affiliation: VA Ann Arbor Healthcare System, Ann Arbor, MI
name: Jacob E Kurlander, MD MS MS
role: PRINCIPAL_INVESTIGATOR
affiliation: VA Ann Arbor Healthcare System, Ann Arbor, MI
name: Jeremy B. Sussman, MD MS
role: PRINCIPAL_INVESTIGATOR
References: