PDF(Pubmed)
Abstract：
Technology can improve implementation strategies\' efficiency, simplifying progress tracking and removing distance-related barriers. However, incorporating technology is meaningful only if the resulting strategy is usable and useful. Hence, we must systematically assess technological strategies\' usability and usefulness before employing them. Our objective was therefore to adapt the effort-vs-impact assessment (commonly used in systems science and operations planning) to decision-making for technological implementation strategies. The approach includes three components - assessing the effort needed to make a technological implementation strategy usable, assessing its impact (i.e., usefulness regarding performance/efficiency/quality), and deciding whether/how to use it. The approach generates a two-by-two effort-vs-impact chart that categorizes the strategy by effort (little/much) and impact (small/large), which serves as a guide for deciding whether/how to use the strategy. We provide a case study of applying this approach to design a package of technological strategies for implementing a 5 A\'s tobacco cessation intervention at a Federally Qualified Health Center. The effort-vs-impact chart guides stakeholder-involved decision-making around considered technologies. Specification of less technological alternatives helps tailor each technological strategy within the package (minimizing the effort needed to make the strategy usable while maximizing its usefulness), aligning to organizational priorities and clinical tasks. Our three-component approach enables methodical and documentable assessments of whether/how to use a technological implementation strategy, building on stakeholder-involved perceptions of its usability and usefulness. As technology advances, results of effort-vs-impact assessments will likely also change. Thus, even for a single technological implementation strategy, the three-component approach can be repeatedly applied to guide implementation in dynamic contexts.
摘要：
技术可以提高实施策略的效率，简化进度跟踪并消除与距离相关的障碍。然而,只有当由此产生的策略可用和有用时，整合技术才有意义。因此，在采用技术策略之前，我们必须系统地评估它们的可用性和有用性。因此，我们的目标是使努力与影响评估（通常用于系统科学和运营计划）适应技术实施战略的决策。该方法包括三个组成部分-评估使技术实施战略可用所需的努力，评估其影响(即，关于性能/效率/质量的有用性)，并决定是否/如何使用它。该方法生成了一个二乘二努力与影响的图表，该图表按努力（小/多）和影响（小/大）对战略进行分类，作为决定是否/如何使用策略的指南。我们提供了一个案例研究，应用这种方法来设计一套技术策略，以在联邦合格的健康中心实施5A的戒烟干预措施。努力与影响图表指导利益相关者参与的有关技术的决策。对技术较少替代方案的规范有助于定制一揽子计划中的每个技术策略（最大程度地减少使策略可用所需的努力，同时最大程度地提高其实用性），与组织优先事项和临床任务保持一致。我们的三部分方法可以对是否/如何使用技术实施战略进行有条理和可记录的评估，基于利益相关者对其可用性和有用性的感知。随着技术的进步,努力与影响评估的结果也可能会发生变化。因此，即使是单一的技术实施战略，三部分方法可以反复应用于动态环境中的指导实现。
