Development of a Toolkit for Implementation of a Diagnostic Terminology

Objectives: Implementation is a challenge across health disciplines. There is evidence that numerous interventions found to be effective in health care research studies fail to be widely adopted. This has also been true for Standardized Dental Diagnostic Terminologies (SDDTs). A common terminology is useful to the extent that it is widely used.

Guided by the Consolidated Framework for Implementation Research (CFIR), we developed an Implementation Toolkit (IT) to guide implementers through a process of goal-setting, deployment, and monitoring of terminology use.
Methods: As part of the first iteration of the IT, academic and nonacademic institutions were recruited to test IT usability. Goal was to understand what was relevant, and obtain improvement recommendations. Data retrieved from the first evaluations informed the development of the second IT iteration.

The second evaluation tested for usefulness by conducting functional analysis of the IT. Participating institutions used the IT as a guide to implement a SDDT. Evaluations were carried out in 3 phases: before, during and after implementation. Data collected was used to develop the third IT iteration.

All evaluations were performed via phone interview using pre-determined semi-structured, open-ended questions and recordings were subsequently transcribed and qualitatively analyzed.
Results: IT Usability - 6 organizations tested the usability of the IT. Qualitative data was grouped in themes to address IT layout, and general and specific IT contents. A total of 37 themes were recorded.

IT Usefulness - 2 organizations tested the IT by implementing the SDDT in their EHR. Currently, one organization has successful completed implementation while the other (implementation and evaluation) is still ongoing.
Conclusions: An Implementation Toolkit can guide dental organizations on the deployment and implementation of Standardized Dental Diagnostic Terminologies.