Table 4 Implementation strategy overview

 Audit and provide feedback

Identify key measures to describe Co-LEC success (for individual stakeholders and for organization). Create weekly reports to share with operations manager, who will use the information to modify the implementation as necessary and report key findings to individuals (e.g. general manager) and groups (e.g. oncologists) based on results.

Knowledge

Enhanced stakeholder awareness of program success and areas that need improvement to encourage program refinement.

 Identify and prepare champions

Identify and prepare an oncologist who will take the lead in promoting the Co-LEC implementation amongst the medical staff, overcoming indifference or resistance and liaising with the management/implementation teams to communicate the needs of the oncologists to ensure they are being met.

Group Norms

Recognition that the Co-LEC service is a part of normal operating procedures within GenesisCare.

 Use an implementation advisor

Appoint a person with implementation experience and programming expertise to guide the project.

Knowledge

Understanding of implementation best practices across stakeholders.

 Conduct educational meetings

Schedule sessions with oncologists during regularly scheduled meetings to provide training and updates regarding the Co-LEC. Organize sessions to teach each administrative group about the Co-LEC and their role in it.

Knowledge

Understanding of Co-LEC vision and overarching implementation plan.

 Develop educational materials

Develop and format “how-to” information sheets to outline the steps of how the Co-LEC operates and the associated workflows.

Knowledge

Understanding of roles and responsibilities for the service.

 Access new funding/use other payment schemes

Utilize the Medicare chronic disease management plan to support the service. Update billing system to capture these payments.

Environmental facilitators

Facilitate financial sustainability of the service.

 Change record systems

Update EMR to include the Co-LEC, so appointments can be captured and all relevant participation information recorded.

Environmental facilitators

Facilitate the recognition that exercise is a standard component of treatment at GenesisCare.

 Revise professional roles

Employ the AEP within GenesisCare; appoint lead PSO to schedule for the Co-LEC; include the Co-LEC tasks in job descriptions for all relevant roles.

Environmental facilitators

Facilitate better intra-organization communication regarding Co-LEC.