Now that you have learned how the Gabby System works, the next step is to implement it at your site. This module provides a step-by-step approach on how to implement the Gabby System.
Learning Objectives:
Identify who is able to use the Gabby System.
Describe the steps involved with Gabby System implementation.
7 Steps to Implement the Gabby System
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The entire Gabby System implementation process can be split into two parts: 1) pre-implementation and 2) implementation. Pre-implementation will take about one to two months, and implementation will take about 6 months, however, the Gabby System has enough content that it can be used for up to 12 months.
Step 1: Assess Site Priorities and Determine if Implementation is the Right Fit
Since the Gabby System is designed to address the needs of young black and African American women, there are conditions that must be met for women to be able to use the Gabby System.
Determine whether your client population meets the following criteria:
African American and black women
Ages 18-39
Not currently pregnant
Computer/ internet access
Once you have determined that your client population meets the criteria, you must then determine if your site has the ability to take on this program at this time. Implementation of a program like this takes time, effort, and resources to ensure proper use and success.
Step 2: Identify Your Site Champion
Once you have concluded that the Gabby System will be a good fit at your site, we recommend that one person be designated the “site champion” or project leader who will be the primary point of contact during the implementation process. This could be an administrator, nurse, or other staff member. Although we recommend only one site champion, multiple frontline staff members can be involved in the implementation process.
The site champion is responsible for:
Creating an implementation plan
Enrolling clients
Monitoring outcomes and reporting progress
Troubleshooting technical problems faced by clients
Once the site champion has been selected, he/she will be in charge of overseeing Gabby System implementation.
Step 3: Create a Process Map
The next step is to determine at which point of your clinical process the Gabby System would fit in. To do this, we recommend creating a process map or visual diagram of your site clinic flow. Your process map will outline all the individuals and activities involved with providing care to clients so that you can identify who will introduce the system to clients and where in the process it will be introduced.
Based on this process map, the best time to introduce the Gabby System is during the monthly visits or community events. The point of entry will be specific to your site. If your site provides educational classes that overlap with the content that the Gabby System provides, that may be the ideal time to introduce the Gabby System and enroll clients. There is no one way to implement the Gabby System. Ideally, you should use the tools we give you to be able to comprehensively think about implementation and ensure the success of implementation.
Step 4: Discuss Facilitators/Barriers and Logistics to Successful Implementation
We recommend that the site champion have conversations with site staff to discuss potential facilitators and barriers that could impact implementation. The purpose of these conversations is to get perspectives from staff at various levels including leadership, administration, and frontline. The buy-in from multiple individuals in different positions will help motivate staff members to learn about Gabby and implement it among their own clients. Discussing facilitators and barriers can address site-specific needs that may not be included in this toolkit. Ideally, staff discussion should occur throughout the planning and implementation process, not only at this point of the process.
Questions to Consider: Logistics
There are several logistic questions that the site staff might want to consider:
Will you enroll only women in preconception or interconception, or both?
How will women take the health survey? Will it be on a laptop during a home visit, on a computer on-site, or will they take it on their own at home?
Who will address the health topics identified by Gabby with the clients? Will it be a nurse, doctor, or other staff member?
Will the discussion with the clients happen during a home visit or during their visit on-site?
Will there be follow-ups with Gabby System clients? If so, when and how often?
Who will follow up with women about any progress they have made?
Will you make referrals to other available resources?
It is critical to answer these questions early on in the process because the answers will affect how you proceed with implementation.
Step 5: Staff Overview
We recommend that the site champion learn how to use the Gabby System so that he/she can train site staff and confidently answer their questions. Staff may have competing priorities so an in-depth training for all site staff may not be a good idea. One approach could be to split up the training into a general overview for all staff members and an in-depth training for frontline staff. This way, all staff members are aware and knowledgeable about the Gabby System, but they can refer to frontline staff or the site champion for specific questions.
During the general training, it is a good idea to cover the history of Gabby and what the system does.
Step 6: Gabby System Training
The site champion may lead a more in-depth training with staff who will be taking part in the enrollment process. This training could include:
Who may use the Gabby System
How to enroll clients
How to use the Administrative Page
Individuals involved in enrollment will need to be more knowledgeable about the Gabby System so that they can confidently answer client questions regarding the Gabby System.
Client Enrollment
When enrolling clients, make sure to fully explain what Gabby is and does. Gabby is designed for their benefit! It may be helpful to provide the client with an informational handout about Gabby in English or in the language primarily spoken by your clients. We have included an example below.
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How to Enroll Clients
Client enrollment is done through the Administrative Page. The Administrative Page is accessible to the site champion and all staff involved in client enrollment.
Information to collect from client:
Nickname/ preferred name (This is what Gabby will call the client!)
Username
Password
Tip: The nickname and username can be the same!
Information created by site staff:
Participant ID Number
On the Administrative Page, you will find a list of all currently enrolled clients as well as the following information for each client:
Topics flagged during the health survey
Baseline stage of change information from the health survey
Number of logins and duration of time spent on each topic
Risk status
This is an example of what the Administrative Page will look like:
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Here you find a status code in the table of risks.
Status Codes:
New: Topic not yet discussed with Gabby
Discussed: Topic already discussed with Gabby
Abandoned: Client no longer wants to talk about topic
Notdiscusseddoctor: Topic not yet discussed with doctor
Step 7: Gabby System Launch
After you have completed all of the steps to get ready for implementation, it is now time for you to launch the Gabby System at your site. To prepare for the launch, it may be helpful to send reminder emails to site staff and confirm that staff understands the system. It is especially important to check in with frontline staff to make sure they feel comfortable enrolling clients and explaining the system to clients.
Key Takeaways:
Before you implement the Gabby System, you must first determine if it is a good fit for your site.
A process map will help you determine at which point of your clinical process the Gabby System would be introduced to clients.
A general training may be helpful for all staff members to learn about the Gabby System.
A more comprehensive training would be useful for frontline staff involved in enrolling clients.
