Module 7: Lessons Learned

A site was initially interested in using the Gabby System, so they completed an introductory call with the research team to learn more about the implementation process. After the call, the director of the site decided not to move forward with implementation due to a lack of staff and competing priorities. The director asked the research team to recontact the site at a later date to discuss the possibility of implementation.

Lessons Learned: The reality is it may not be feasible to implement the Gabby System at your site because of other projects, lack of time, limited staff, or other considerations. Although you may be interested in implementing the system, you might decide that this is not the best time for you to do so. Ideally, you do not want implementation to feel like a burden for you or other staff members. If you decide later on that it is an appropriate time to implement the Gabby System, you can always refer back to this toolkit.

A site felt that they had the appropriate resources to implement the Gabby System and decided to move forward with the process. One staff member was selected to be the site champion. This individual was responsible for overseeing the Gabby System implementation process, which included leading trainings and enrolling clients. For higher-level decisions that may have a significant impact on existing workflow and operations, the site champion consulted with the manager and primary contact of the site, but all other aspects of implementation were the responsibility of the site champion.

Lessons Learned: You may choose to follow this targeted approach, where the site champion’s sole responsibility is Gabby System implementation or you may choose an all-staff approach. The all-staff approach involves multiple individuals at the site being involved in implementation. With a targeted approach, there is one site champion who leads implementation, but other staff members are involved during the process, including enrollment and follow-up. Although the site champion will be responsible for implementation, it is always a good idea to consult site leadership to advise aspects of the process. The approach your site chooses to use depends on the existing responsibilities, capacity, and motivation of staff members.

A site discussed the possibility of enrolling clients over the phone, rather than enrolling clients when they are at the site. During their visit to the site, the research team confirmed that phone enrollment was a feasible option. Together, the research team and site staff created a new approach where site staff could enroll clients over the phone and email the Gabby System access link and login information to the client.

Lessons Learned: If you find that in-site enrollment may not be ideal, it may be helpful to consider using an additional enrollment strategy or shift strategies along the way. The best enrollment approach will be entirely dependent on your site. You can enroll clients over the phone, while they are in the waiting room at your site, during home visits, or at community events. Keep in mind that whichever approach you use, you must still be aware of who is able to use the Gabby System, if the client is eligible to participate, how you will enroll them and provide them with their login information, and how you will track any ongoing communication with the client.

One site experienced very high enrollment rates in terms of the number of people who agreed to sign up and use the Gabby System. The site champion identified eligible clients before implementation started. Once rollout began, she contacted the clients and scheduled clinic visits as a way to enroll them into the Gabby System. During this visit, the clients also took the health survey. In addition to contacting eligible participants, the site champion identified other potential clients in the waiting room of the clinic. Women who agreed to participate were then asked to complete the health survey and were given a Gabby swag bag which included the Gabby System access link and their login information so that they could use Gabby at home. After the health survey, the site champion asked the women to schedule a preventive visit with a primary care physician (PCP) in a month or two to follow up on the risks that the Gabby System flagged.

During a call with the research team, the site champion was made aware that the health survey did not need to be completed at the site, but could be completed at home. The site champion was relieved since the health survey took a while to complete.

Lessons Learned: Having a variety of enrollment strategies was successful for this site. Although the health survey can be completed at home, completing it on-site allowed staff to ensure that it is completed. However, since it takes on average 20 minutes, it may be more efficient for you to ask the client to complete it at home. Providing clients with a gift after enrollment also incentivizes clients to take the health survey and use the Gabby system.