Implement

Program Deployment

The Goals in this section will help you implement an early detection program and start screening patients for cognitive impairment.

Goal

Develop a comprehensive implementation schedule.

These Actions will help you outline the program timeline and milestones. Your schedule will help all stakeholders understand the timing and dependencies of key activities, including the contributions required of each stakeholder group.

3 Actions

Goal

Develop a patient recruitment plan.

These Actions will help you outline the process by which you will recruit and enroll patients in your early detection program for cognitive impairment. Depending on your healthcare system context, you may enroll existing patients or you may need to develop an outreach strategy to raise awareness and facilitate patient recruitment.

2 Actions

Goal

Set up the clinic space, electronic medical records, and information technology systems.

These Actions will help you create a clinic environment that supports your early detection program for cognitive impairment. You will also create processes for administering your cognitive assessment tool and collecting data. These processes will depend on the type of tool you have selected and your medical records system (digital or paper). If using digital tools or technology, you will also establish the electronic medical record (EMR) protocol for early detection assessments and the information technology (IT) management system for cognitive assessment.

2 Actions

Goal

Pilot and test workflows.

These Actions will help you test operational workflows to catch bottlenecks and problematic areas before launching the program. Update workflows and clinic policies as you discover challenges, risks, and inefficiencies.

3 Actions

Goal

Initiate program roll-out.

These Actions will help you start the early detection program for cognitive impairment with real patients. You will recruit patients, follow testing protocols and workflows, and gather feedback to resolve issues.

2 Actions

Develop a comprehensive implementation schedule.

The Actions below will help you outline the program timeline and milestones. Your schedule will help all stakeholders understand the timing and dependencies of key activities, including the contributions required of each stakeholder group.

Action

Draft an implementation timeline.

Determine the major phases and the necessary completion order for key activities.
Establish any dependencies between phases and activities, and consider the resources required for successful execution of each phase or activity.
Estimate how long each phase and the key activities within may take to complete. Use these approximate times to set milestones and deadlines.
Assign responsibilities to the appropriate team members and confirm their accountability.
Confirm that the monitoring and evaluation metrics (defined in Goal 6) align with the milestones and include your evaluation schedule in the timeline.

Action

Iterate the implementation timeline with core program team members.

Meet with the core program team to identify potential areas of failure (e.g., conduct a risk assessment exercise such as the pre-mortem activity). Use this information to preemptively strengthen your implementation plan accordingly.
Re-assign responsibility for key actions to team members, as required, to meet the revised timeline. Ensure there is clarity among team members of who is accountable for what.
Solicit feedback from team members regularly to address potential issues regarding the implementation timeline.

Action

Communicate the implementation timeline with key stakeholders.

Meet with the involved stakeholder groups to kick off the program and communicate the scope and its objectives, implementation timeline, responsibilities, and governance and reporting structure. It may be necessary to hold multiple kick-off meetings, depending on your healthcare system context. For instance, you may need to conduct separate meetings for internal and external stakeholders.
Engage stakeholders during and after the kick-off meetings to continually seek input, alignment, and build buy-in for the program.

Initiate program roll-out.

The Actions below will help you start the early detection program for cognitive impairment with real patients. You will recruit patients, follow testing protocols and workflows, and gather feedback to resolve issues.

Action

Launch the program and start conducting cognitive assessments.

Action

Document the program's progress as planned.

Pilot and test workflows.

The Actions below will help you test operational workflows to catch bottlenecks and problematic areas before launching the program. Update workflows and clinic policies as you discover challenges, risks, and inefficiencies.

Action

Simulate patient interactions to assess the effectiveness of various operational workflows.

Consider using a small group of patients or staff members acting as patients to dry-run actual visits in the clinic. If possible, leverage local standardized patient programs that may already be a part of educational institutions in your health network.

Action

Gather feedback and document challenges.

Document gaps and challenges that were uncovered by the patient simulation. This may include items required by staff (e.g., scripts, patient consent documents, etc.), training gaps, issues with health record documentation, disclosure scripts for providers to deliver results to patients, handoffs within the clinic, etc. If you are using digital cognitive assessments, consider the unique needs that may include WiFi access, platform logins, missing equipment, etc.

Action

Identify improvement opportunities.

Identify improvement opportunities and adjust the workflow accordingly.

Set up the clinic space, electronic medical records, and information technology systems.

The Actions below will help you create a clinic environment that supports your early detection program for cognitive impairment. You will also create processes for administering your cognitive assessment tool and collecting data. These processes will depend on the type of tool you have selected and your medical records system (digital or paper). If using digital tools or technology, you will also establish the electronic medical record (EMR) protocol for early detection assessments and the information technology (IT) management system for cognitive assessment.

Action

Design the physical clinic layout to support the new workflow.

Consider the space, furniture, and equipment required to enable consistent and reliable delivery of cognitive assessments (e.g., privacy, light, quiet space).
Note the interdependencies between this Goal and training (Goal 10), this will allow for ongoing updates and improvements to training to keep consistent with the setup and workflow.

Action

Set up the cognitive assessment process and tools.

If performing a digital cognitive assessment, prepare the required equipment (e.g., tablets, stylus, Wi-Fi, electrical outlet).
Work with operational teams and relevant systems (e.g., IT, EMR) to create the data collection, sharing, and security needed for any protected health information.
If manual data entry is required, establish the process for receiving and entering results into the patient’s medical record.

Develop a patient recruitment plan.

The Actions below will help you outline the process by which you will recruit and enroll patients in your early detection program for cognitive impairment. Depending on your healthcare system context, you may enroll existing patients or you may need to develop an outreach strategy to raise awareness and facilitate patient recruitment.

Action

Recruit current patients from your clinic.

If you are in a clinic or healthcare system where patients have regular preventative medical appointments, such as an Annual Wellness Visit, you may be able to enroll current patients from your clinic.
Assess your client roster for eligible patients that fit your target audience.
Prepare communication materials to inform patients that a cognitive assessment will now be part of their visit. This may be in the form of a pamphlet, email, notification via your patient portal, or script that can be read by clinic administrative staff.

Action

Recruit patients using outreach and advertising strategies.

If you are in a clinic or healthcare system that does not offer preventative medical appointments or patients do not have access to a primary care physician, you may require an outreach strategy to recruit patients.
Determine your outreach approach, considering how you plan to connect with your target population. You may choose to create partnerships with local advocacy organizations and patient support groups, community or cultural organizations, or other local agencies.
Determine what outreach content needs to be created and the most suitable format(s), such as a website or pamphlets. Include information about the early detection program and the importance of screening for cognitive impairment.
Ensure all materials are accessible and culturally-sensitive for your target audience(s). Consider the local languages and cultures, patient access to technology, and reading level of the materials.
Collect feedback on your materials and test any links or QR codes to find and correct errors before distributing.
Create a distribution schedule for the outreach materials that aligns with the implementation timeline from Goal 11.

Program Deployment

Develop a comprehensive implementation schedule.

Develop a patient recruitment plan.

Set up the clinic space, electronic medical records, and information technology systems.

Pilot and test workflows.

Initiate program roll-out.

Develop a comprehensive implementation schedule.

Draft an implementation timeline.

Iterate the implementation timeline with core program team members.

Communicate the implementation timeline with key stakeholders.

Initiate program roll-out.

Launch the program and start conducting cognitive assessments.

Document the program's progress as planned.

Pilot and test workflows.

Simulate patient interactions to assess the effectiveness of various operational workflows.

Gather feedback and document challenges.

Identify improvement opportunities.

Set up the clinic space, electronic medical records, and information technology systems.

Design the physical clinic layout to support the new workflow.

Set up the cognitive assessment process and tools.

Develop a patient recruitment plan.

Recruit current patients from your clinic.

Recruit patients using outreach and advertising strategies.

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DAC-SP Early Detection Blueprint