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This document introduces and explains common implementation concepts and frameworks relevant to healthcare epidemiology and infection prevention and control and can serve as a stand-alone guide or be paired with the “SHEA/IDSA/APIC Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals: 2022 Updates,” which contain technical implementation guidance for specific healthcare-associated infections. This Compendium article focuses on broad behavioral and socio-adaptive concepts and suggests ways that infection prevention and control teams, healthcare epidemiologists, infection preventionists, and specialty groups may utilize them to deliver high-quality care. Implementation concepts, frameworks, and models can help bridge the “knowing-doing” gap, a term used to describe why practices in healthcare may diverge from those recommended according to evidence. It aims to guide the reader to think about implementation and to find resources suited for a specific setting and circumstances by describing strategies for implementation, including determinants and measurement, as well as the conceptual models and frameworks: 4Es, Behavior Change Wheel, CUSP, European and Mixed Methods, Getting to Outcomes, Model for Improvement, RE-AIM, REP, and Theoretical Domains.
Substance abuse treatment has been a topic of ongoing debate in the United States since at least the 1960s, when the country witnessed the development of several promising new treatment approaches. Although costs to society in connection with substance abuse point to a continuing need for an effective treatment system, there is only a general understanding of the field. Several factors make it difficult to comprehend the treatment structure: the field is comprised of a sprawling combination of public and private facilities, it strives to treat many types of addicts, and it employs a variety of treatment approaches. While there are general studies that attempt to describe the system and its components, few inquiries probe the inside of specific treatment facilities to discern their evolution, mission, and effectiveness. This article, which examines the Antelope Valley Rehabilitation Centers (AVRCs), is one such analysis. Located in rural areas sixty miles from downtown Los Angeles, the AVRCs are Los Angeles County's only directly operated treatment centers. The two centers, at Acton and Warm Springs, are not only the first and fourth largest substance abuse hospitals in the country, but they serve a population larger than that of forty-two states, making them an excellent lens through which to view a portion of the substance abuse treatment system.
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