The Participant-Reported Implementation Update and Score (PRIUS): a new method for capturing implementation-related developments over time

Miech EJ, Damush TM, Rattray NA, Myers J, Homoya B. The Participant-Reported Implementation Update and Score (PRIUS): a new method for capturing implementation-related developments over time. [Abstract]. Implementation Science. 2017 Apr 20; 12(Suppl 1):48.

Background: A new "TeleSleep" quality improvement (QI) program was implemented in 2016 at the Roudebush VA Medical Center in Indianapolis that brought the staff of the local Sleep and Telehealth services together for the first time. The Implementation Core (IC) of the VA Precision Monitoring (PRIS-M) QUERI sought to understand how staff in different services and job positions experienced and perceived ongoing implementation of the QI initiative. Methods: The Participant-Reported Implementation Update and Score ("PRIUS") is a five-minute check-in method developed and piloted by the VA PRIS-M IC designed to elicit how key participants view implementation at different points in time. PRIUS sessions took place approximately every two or three weeks as an in-person or phone conversation between participant and IC member. Participants responded verbally to the question "What are some things that happened over the past 2-3 weeks that seem relevant from your perspective to the implementation of the TeleSleep project"? Participants then verbally scored each reported "update" with a number ranging from +3 to -3. Positive scores indicated a positive influence on the implementation process; negative scores indicated a negative influence; and zero indicated neutral influence. A "3" indicated a strong influence, "2" moderate, and "1" weak. Findings: Five members of the IC conducted PRIUS sessions with 12 different staff members involved in the Telesleep project over a 6-month period in 2016. There were 62 different PRIUS sessions containing a total of over 225 updates; the average PRIUS session had 3-4 updates. New PRIUS entries were discussed twice a month during IC meetings; major developments and themes were shared with the lead investigator of TeleSleep. PRIUS findings included that Sleep and Telehealth staff reported fundamentally different perspectives on TeleSleep implementation; that the TeleSleep project coordinator played a key boundary-spanning role critical to implementation success; and that a seemingly modest event (a catered "appreciation" lunch for TeleSleep staff) unexpectedly proved to be a turning point in TeleSleep implementation. Implications for DandI Research: The PRIUS method provides an efficient, structured way to elicit and capture perspectives of diverse participants on local implementation-related developments over time, generating new sources of both qualitative and numerical data for analysis.