Launch Process

How will you launch the program?

Identify sites to pilot the tobacco treatment program (TTP). Most C3I programs piloted in one or two sites (often radiation oncology, head-and-neck, and/or lung cancer clinics) before expanding center- and network-wide. Launch your program in pilot sites where you have engaged clinic champions who will be early adopters of the intervention.

Refine the TTP through multiple Plan-Do-Study-Act (PDSA) cycles. This rapid quality improvement model enables teams to test and adapt processes in their local contexts and make timely changes to optimize implementation.

1. 1. Adaptation targets include:
    1. Modifying EHR user displays and navigation efficiency. See the Pre-Implementation Module Screening Tools and Treatment Tools pages for EHR build guides and sample screenshots.
    2. Better aligning tobacco treatment with health system goals, such as accreditation standards and quality metrics.
    3. Defining role responsibilities and tailoring training to support the workflows. Additional resources for assembling and training teams can be found in the Pre-Implementation Program Planning Tool.
    4. Creating clinician communication loops to provide actionable feedback (like this sample clinic activity report on electronic quitline referral performance at one clinic).
  2. C3I example: See Case Study H for an example of a C3I program that utilized PDSA rapid-cycle quality improvement to test incremental changes and successfully adapt a point-of-care workflow to various clinical settings.

Scale up. Continue to launch and refine the TTP in new settings as you expand the program throughout your organization. The Practical, Robust Implementation and Sustainability Model iPRISM webtool can help your team iteratively assess the context and fit of your program as you expand to new settings.

1. Expansion strategies include:
  1. Identifying and engaging clinic champions at each new expansion site to enhance adoption
  2. Highlighting pilot program successes to enhance buy-in
  3. Conducting gemba walks, soliciting clinic staff input, and tailoring the intervention to fit existing systems and cultures in each setting
  4. Refining new workflows through PDSA cycles and local adaptations
  5. Establishing ongoing trainings to ensure staff adopt the workflow, even when turnover occurs
  6. Reporting program outcomes back to staff
2. C3I example: See Case Studies C and G for additional examples of C3I programs’ expansion strategies.

Roadmap Navigation

Advice from a C3I Grantee

“Programmatic adoption occurred in stages… This gradual expansion allowed for piloting the BPA first in a few sites, revealing a need to modify the EHR.”