Trial reportJournal of general internal medicine2021
Implementation Evaluation of a Complex Intervention to Improve Timeliness of Care for Veterans with Transient Ischemic Attack.
Trial report in Journal of general internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02769338 (Protocol-guided Rapid Evaluation of Veterans Experiencing New Transient Neurological Symptoms), which is not on this map. Cited by 17 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Protocol-guided Rapid Evaluation of Veterans Experiencing New Transient Neurological Symptoms (PREVENT) (QUE 15-280)
Who cites it
17 citing papers in PubMed, 23 citations in OpenAlex.
- Quality Improvement Intervention to Increase Sleep Apnea Diagnostic Testing After Stroke and Transient Ischemic Attack: A Cluster Randomized Trial.JAMA network open · 2025Trial
- Successful and sustained implementation of a behaviour-change informed strategy for emergency nurses: a multicentre implementation evaluation.Implementation science : IS · 2024Trial
- Acceptability of a complex team-based quality improvement intervention for transient ischemic attack: a mixed-methods study.BMC health services research · 2021Trial
- Barriers and facilitators of the implementation of a leadership training program based on the Developing and Sustaining Nursing Leadership Best Practice Guideline: A qualitative study.International journal of nursing sciences · 2026Article
- Difference-making factors in implementing a quality improvement program for sleep apnea in stroke/TIA patients.Implementation science communications · 2026Article
- Explaining site-level fidelity within a national initiative to implement a VA patient safety guidebook: the difference-making role of networks & communications.Implementation science communications · 2025Article
- Implementation science promotes clinical practice of guidelines: a scoping review.BMC health services research · 2025Article
- Combined use of the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework with other implementation frameworks: a systematic review.Implementation science communications · 2025Review
- Using a "Kickoff" to build implementation partner teams and action plans for active implementation of a quality improvement project.Frontiers in health services · 2025Article
- Virtual practice facilitation as an implementation strategy for launching opioid safety committees for quality improvement in primary care: feasibility, acceptability, and intervention fidelity.BMC primary care · 2024Article
- Article
- Cost-Effectiveness of Increased Use of Dual Antiplatelet Therapy After High-Risk Transient Ischemic Attack or Minor Stroke.Journal of the American Heart Association · 2024Article
- Review
- Factors That Affect Opioid Quality Improvement Initiatives in Primary Care: Insights from Ten Health Systems.Joint Commission journal on quality and patient safety · 2023Article
- The Perils of a "My Work Here is Done" perspective: a mixed methods evaluation of sustainment of an evidence-based intervention for transient ischemic attack.BMC health services research · 2022Article
- Quality of Care and Outcomes for Patients with Acute Ischemic Stroke and Transient Ischemic Attack During the COVID-19 Pandemic.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2022Article
- Implementation Science to Improve Quality of Neurological Care.Pediatric neurology · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundThe Protocol-guided Rapid Evaluation of Veterans Experiencing New Transient Neurologic Symptoms (PREVENT) program was designed to address systemic barriers to providing timely guideline-concordant care for patients with transient ischemic attack (TIA).
objectiveWe evaluated an implementation bundle used to promote local adaptation and adoption of a multi-component, complex quality improvement (QI) intervention to improve the quality of TIA care Bravata et al. (BMC Neurology 19:294, 2019).
designA stepped-wedge implementation trial with six geographically diverse sites.
participantsThe six facility QI teams were multi-disciplinary, clinical staff.
interventionsPREVENT 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 & Evaluating, Planning, and Goals & Feedback. MAIN MEASURES: 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 > 15 points improvement in the Without Fail Rate (WFR) over 1 year. KEY
resultsFacility 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 & Evaluating, Goals & Feedback, and Planning (rather than the other way around), helping to explain how champions at the +2 level influenced ongoing implementation.
conclusionsThe 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.
trial registrationclinicaltrials.gov: NCT02769338.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.