# Implementation Core

> **NIH NIH U19** · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · 2024 · $1,381,739

## Abstract

PROJECT SUMMARY
The primary roles of the Implementation Core are to: 1) harmonize core functions and processes; 2) optimize
and integrate clinical decision support; and 3) enable training and intervention fidelity across the three
interventions. The Implementation Core Lead, Grudzen (mPI), and the Core Director will oversee
harmonization, adaptation, and fidelity monitoring with input from the project leads (Chodosh, Brody, Shah), an
implementation scientist (Mittman), qualitative methodologists (Dickson and Arbaje). They will oversee
optimization of clinical decision support in collaboration with a lead informatician (Mann). These seasoned
collaborators are supported by a rich research infrastructure and personnel with expertise in the
implementation of complex health interventions across multiple settings in older adults with serious illness.
NYU Grossman School of Medicine, NYU Rory Meyers College of Nursing, University of Wisconsin-Madison,
Memorial Sloan Kettering, and the mPI team have substantial expertise in harmonizing core functions of
complex interventions, enabling high fidelity across multi-site pragmatic trials in diverse settings, and tailoring
usable clinical decision support tools across variable electronic health record (EHR) platforms. To ensure
tailoring to local contextual factors across settings, the Implementation Core Steering Committee will engage
the Lived Experience Panel and Lived Practice Panel to pre-specify allowable adaptations in form, including
the mode of delivery, providers involved, materials or tools needed, dose, and frequency/intensity. Besides
overseeing all aspects of the core, the Implementation Core Lead Grudzen and the Core Director will lead
strategy to monitor and continually improve implementation. They will first conduct a needs assessment and
assess readiness at each site to develop a tailored implementation blueprint. This will include detailed standard
operating procedures that describe implementation strategies and how planned and unplanned adaptations will
be managed, measured/documented, and reported over time. They will, in coordination with the Administrative
Core, oversee the fidelity of each intervention to ensure all core functions are performed during the triadic
encounters. Approaches to achieve high fidelity will include pilot testing at multiple sites; identifying nurse,
physician, and social work champions at each ED; establishing peer-to-peer learning networks; and using
evaluative and iterative tools until fidelity targets are met. Cyclical small tests of change during pilot testing will
identify optimal implementation strategies. The lead informatician will direct the processes used to optimize the
clinical decision support and ensure that documentation and communication between internal and external
members of the care team are both compliant and seamless. A data manager will work with sites to establish
their EHR builds and extraction methods. An informatics analyst will ensure...

## Key facts

- **NIH application ID:** 10929965
- **Project number:** 5U19AG078105-02
- **Recipient organization:** NEW YORK UNIVERSITY SCHOOL OF MEDICINE
- **Principal Investigator:** Corita R Grudzen
- **Activity code:** U19 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,381,739
- **Award type:** 5
- **Project period:** 2023-09-15 → 2028-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10929965

## Citation

> US National Institutes of Health, RePORTER application 10929965, Implementation Core (5U19AG078105-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10929965. Licensed CC0.

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