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INNOVATION AND IMPROVEMENT
A Training Model for Implementing Hepatitis Prevention Services in Substance Use Disorder Clinics: A Qualitative Evaluation
Hildi J. Hagedorn, PhD1,2, Nancy Rettmann, MS1, Eric Dieperink, MD2,3, Astrid Knott, PhD3, and BruceE. Landon, MD, MBA, MSc4,5
1Substance Use Disorders Quality Enhancement Research Initiative, Minneapolis VA Health Care System, Minneapolis, MN, USA; 2Department of Psychiatry, School of Medicine, University of Minnesota, Minneapolis, MN, USA; 3Department of Psychiatry, Minneapolis VA Health Care System, Minneapolis, MN, USA; 4Department of Health Care Policy, Harvard Medical School, Boston, MA, USA; 5Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA, USA.
KEY WORDS: Implementation; Hepatitis; Prevention; Substance Use Disorders.
J Gen Intern Med 30(8):121521DOI: 10.1007/s11606-015-3317-3 Society of General Internal Medicine 2015. This article is published with open access at Springerlink.com
Editors note: In this installment of Implementation Science Workshop, Dr. Hagedorn and colleagues describe implementation and evaluation of a liver health training program at the Minneapolis VA. In an accompanying commentary, Bruce Landon, MD, MBA, MSc, of Harvard Medical School highlights the distinction between evaluating the process and effectiveness of an intervention, important components of implementation science.
CASE
INTRODUCTION
Drug- and alcohol-dependent individuals are at a much higher risk for hepatitis infections than the general population and are at higher risk of poor outcomes following infection.113 Because of these risk factors, substance use disorder treatment clinics represent an ideal venue for screening, education, prevention, and treatment referral services for patients with hepatitis infections.
The Liver Health Initiative (LHI) was a training program jointly sponsored by the Veterans Health Administrations (VA) Substance Use Disorders Quality Enhancement Research Initiative (SUD QUERI) and the Minneapolis VA Hepatitis C Resource Center (HCRC), with the goal of implementing these services in VA SUD clinics. The program
was based on a successful liver health program established in the Minneapolis VA Health Care Systems Addictive Disorders Service14 and a training model previously used by the HCRC to promote evidence-based evaluation and treatment of patients with hepatitis C.15 The program design was informed by empirically based literature on the education of medical providers and the dissemination of health care innovations.16
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The purpose of this paper is to describe the LHI training model, which shows promise for promoting implementation of hepatitis...