Stagewise Implementation-To-Target- Medications for Addiction Treatment (SITT-MAT)

The proportion of program patients with OUD and receiving MOUD (buprenorphine, naltrexone) within the index quarter.

The number of integrated prescribers of buprenorphine and/or naltrexone, who are actively prescribing MOUD.

Access: The proportion of patients prescribed MOUD who start the medication within 72 hours of diagnosis. For patients requiring detoxification for naltrexone, Access will be operationalized as the proportion of patients who start the medication within 72 hours of when it is safe or indicated by a physician. Retention: The proportion of patients who are retained in continuous care for at least 6-months from the start of medication, or if in time limited care situations (e.g., residential detoxification) for the entire treatment episode.

The IMAT integrates MOUD guidelines, expert consensus recommendations, the OUD care cascade, and best practice information into a team-assessment benchmark measure of current and future state MOUD capability and practice. The IMAT is composed of 45 items, rated on a 1 to 5 scale from: 1- Not Integrated, to 3- Partially integrated, to 5- Fully integrated. Intermediate ratings of 2 and 4, are ratings not at either a 3 or 5 level respectively. The benchmark items address policy, practice and workforce factors, and are clustered into seven dimensions of: 1) Infrastructure; 2) Clinic culture and environment; 3) Patient identification and initiating care; 4) Care delivery and treatment response monitoring; 5) Care coordination; 6) Workforce; and, 7) Staff training and development. The IMAT Total Score is a composite rating from 1 to 5 of overall MOUD care quality. It takes between 1 to 2 hours to complete.

Inventory of Factors Affecting Successful Implementation and Sustainment (IFASIS). The IFASIS evaluates contextual aspects at baseline and over time. This measure focuses on four dimensions (Outer Context, Inner Context, Perception of Intervention, Perception of Patient/Client Experience). tHE IFASIS is a team-assessment measure completed by key staff in MOUD implementation. In addition to individual item scores, it generates a score for each of the four dimensions and in total.

Stages of Implementation Completion (SIC). The SIC is an 8-stage assessment tool designed to measure and compare implementation strategies for scaling up proven interventions. Stages range from Engagement (Stage 1) to achievement of program delivery with Competency (Stage 8). SIC data include a log of activities that operationalize the implementation process necessary to move toward successful program start-up and sustainment, and their completion dates. Two scores are calculated for each SIC stage. The Proportion score calculates the proportion of key activities completed within a stage. The Duration score is calculated by date of entry through date of final activity completed. The Duration Score can account for activities not completed sequentially and also for being in multiple stages at a given time. A third Final Stage score indicates the final stage achieved in the implementation process (Stage 1-8).

Cost of Implementing New Strategies (COINS). Calculations of fees, expenses, and person hours necessary to complete each implementation stage.

NIATx Fidelity. The NIATx Fidelity Scale is a 19-item observational measure of adherence to the NIATx model, rating activities on a 5-point scale from 1-No evidence to 5-Extensive evidence. Scoring reflects information obtained from IF and EF perspectives using a composite of interviews, review of walk-through results, change project forms, EF or IF notes and sustainability plans.

Implementation Climate Scale (ICS). Assesses the extent to which an organization prioritizes and values the implementation of an evidence based practice. Six subscales and 18 items scored on a 5-point scale from 0 - not at all, to 4 - very great extent

Implementation Leadership Scale (ILS). Assesses a leader's support for implementation of an evidence based practice. Four subscales and 12 items scored on a 5-point scale from 0 - not at all, to 4 - very great extent