Bidwell, P

Gurol-Urganci, I

Jurczuk, M

Sevdalis, N

Silverton, L

Thakar, R

Van der Meulen, J

Wolstenholme, D

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Implementation Science 2020, 15(Suppl 4):105https://doi.org/10.1186/s13012-020-01062-3MEETING ABSTRACTS Open AccessProceedings of the Virtual 3rd UKImplementation Science ResearchConferenceVirtual conference. 16 and 17 July 2020Published: 17 December 2020Institute of Psychiatry, Psychology andNeuroscience, King’s College London,16th and 17th July 2020© The Author(s). 2020 Open Access This articwhich permits use, sharing, adaptation, distribappropriate credit to the original author(s) andchanges were made. The images or other thirlicence, unless indicated otherwise in a creditlicence and your intended use is not permittepermission directly from the copyright holderThe Creative Commons Public Domain Dedicadata made available in this article, unless othele is licensed under a Creative Commons Attribution 4.0 International License,ution and reproduction in any medium or format, as long as you givethe source, provide a link to the Creative Commons licence, and indicate ifd party material in this article are included in the article's Creative Commonsline to the material. If material is not included in the article's Creative Commonsd by statutory regulation or exceeds the permitted use, you will need to obtain. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.tion waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to therwise stated in a credit line to the data.Table 1 (abstract P40). Discrete implementation strategies to be usedin each group of participating unitsDiscreteImplementationStrategy/ group ofstrategies [4]SustainabilitygroupPeerimplementationLeanimplementationImplementationrequirementsIdentify and preparechampions/Facilitation/Clinical supervisionx x xDevelop andorganize qualitymonitoring systems/changerecord systems/Audit & providefeedback / facilitate relay ofclinical data to providersx x xDevelop a formal implementationblueprint/ develop animplementation glossaryx x xConduct educationalmeetings (clinicians)x x xUse educationalmaterials(toolkit resources)x x xRemind clinicians:pens, posters, stickers(care bundle launchday and promotethe care bundlecontinuously)x x xObtain and usepatient feedback/Prepare patients/consumers to be activeparticipants(engage local PPI group)x x xStrategiesexclusive toexternalfacilitationCentralise technicalassistance/ Providelocal technical assistance/Use animplementation advisor/Provide ongoingconsultationCentralisedtechnicalassistanceLocal technicalassistanceOrganize clinicianimplementation teammeetings (skillsdevelopmentdays led byexternal facilitators)x xCreate a learningcollaborative/Promotenetwork weavingx xUse train thetrainer strategiesProject Team >clinicians throughcascadeExternalfacilitators >clinicians throughcascadeStrategiesrelated tosustainabilityeffortsConduct educationaloutreach visitsSite visits fromProject TeamInvolve executive boards Ensure senior-buyinMandate change/ Create orchange credentialing and/orlicensure standardsBundle introducedinto mandatorytraining/ inductionpackagesFund & contract for the clinicalinnovationProtected timeor championsRevise professional roles Formal titles forchampionsRecruit, designate, train forleadershipChampionstrained forexternal facilitatorroleImplementation Science 2020, 15(Suppl 4):105 Page 20 of 22P40.OASI2: a hybrid effectiveness implementation RCT to inform scaleup of care bundle to reduce obstetric anal sphincter injury (OASI)caused during childbirthMagdalena Jurczuk1, Posy Bidwell1, Daniel Wolstenholme1, LouiseSilverton2, Jan Van Der Meulen3, Nick Sevdalis4§, Ipek Gurol-Urganci1,3§,Ranee Thakar5§1Centre for Quality Improvement and Clinical Audit, Royal College ofObstetricians and Gynaecologists, London SE1 1SZ, UK; 2Royal College ofMidwives, London W1G 9NH, UK; 3Department of Health ServicesResearch and Policy, London School of Hygiene and Tropical Medicine,London WC1H 9SH, UK; 4Centre for Implementation Science, HealthService and Population Research Department, King’s College London,London SE5 8AF, UK; 5Croydon University Hospitals NHS Trust, CroydonCR7 7YE, UKCorrespondence: Magdalena Jurczuk (mjurczuk@rcog.org.uk)Implementation Science 2020, 15(Suppl 4):P40.§ Authors Ranee Thakar, Nick Sevdalis and Ipek Gurol-Urganci contrib-uted equally to the study and share senior authorshipBackgroundObstetric anal sphincter injuries (OASI) can have severe debilitatingconsequences for women. A large-scale quality improvement study(OASI1; 2017-18) implemented a care bundle (antenatal information towomen, manual perineal protection and mediolateral episiotomy whenindicated) in 16 maternity units in Britain [1] which reduced OASI rates.OASI2 (2021-22) is a scale-up study, which examines strategies used tointroduce, implement and sustain implementation.MethodOASI2 is a cluster-randomised control trial with two arms. Arm 1 (peer-to-peer implementation, n=10) is supported by peer units. Arm 2 (lean imple-mentation, n=10) does not receive any active implementation support. Aparallel nonrandomised study group (sustainability arm) consisting of ori-ginal OASI1 units, allows study of the care bundle’s sustainability over time.An estimated 2,750 singleton live births/unit will be eligible for the carebundle. All three study groups receive an implementation toolkit includingtraining resources. Table 1 details the expected implementation strategiesacross the three arms. Clinical outcomes (OASI rates) are collated from ma-ternity information systems; implementation outcomes (acceptability, feasi-bility, appropriateness, sustainability) are collected through validatedsurveys [2,3] administered to women and clinicians, supplemented by quali-tative research. Quantitative data are analysed using regression modellingand descriptive statistics.ResultsThe trial will identify the effect of the applied implementation strategies[4] on implementation success, and link that to the clinical effectivenessof the bundle. Successful sustainability strategies will be identified.ConclusionThe study will generate insights into how to effectively scale-up andsustain uptake and coverage of similar interventions in maternityunits. A locally adaptable ‘implementation blueprint’, will be pro-duced to inform development of future guidelines to prevent peri-neal trauma.AcknowledgementsThe study is funded by the Health Foundation. NS’s research is supported bythe NIHR Applied Research Collaboration South London. We are also gratefulto our independent advisory group who have contributed to theconceptualization, design and implementation of both the OASI1 and theOASI2 studies.Trial RegistrationTrial registration pending completion of research protocol.References1. Bidwell P, Thakar R, Sevdalis N, Silverton L, Novis V, Hellyer A, et al. Amulti-centre quality improvement project to reduce the incidence of ob-stetric anal sphincter injury (OASI): Study protocol. BMC Pregnancy Child-birth. 2018;18(1):1–33.2. Weiner BJ, Lewis CC, Stanick C, Powell BJ, Dorsey CN, Clary AS, et al.Psychometric assessment of three newly developed implementationoutcome measures. Implement Sci. 2017;12(1):1–12.3. University W. Clinical Assessment Sustainability Tool. 2012.4. Powell BJ, Waltz TJ, Chinman MJ, Damschroder LJ, Smith JL, MatthieuMM, et al. A refined compilation of implementation strategies: Resultsfrom the Expert Recommendations for Implementing Change (ERIC)project. Implement Sci. 2015;10(1):1–14.Implementation Science 2020, 15(Suppl 4):105 Page 22 of 22Publisher’s NoteSpringer Nature remains neutral with regard to jurisdictional claimsin published maps and institutional affiliations.

OASI2: a hybrid effectiveness implementation RCT to inform scale up of care bundle to reduce obstetric anal sphincter injury (OASI) caused during childbirth

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OASI2: a hybrid effectiveness implementation RCT to inform scale up of care bundle to reduce obstetric anal sphincter injury (OASI) caused during childbirth

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