title: "We have to what?": lessons learned about engaging support staff in an interprofessional intervention to implement MVA for management of spontaneous abortion.
abstract: BACKGROUND
  Including support staff in practice change initiatives is a promising strategy to successfully implement new reproductive health services. The Resident Training Initiative in Miscarriage Management (RTI-MM) is an intervention designed to facilitate implementation of manual vacuum aspiration (MVA) for management of spontaneous abortion. The purpose of this study was to identify training program components that enhanced interprofessional training and provide lessons learned for engaging support staff in implementing uterine evacuation services.
  
  
  METHODS
  We conducted a secondary analysis of qualitative data to identify themes within three broad areas: interprofessional education, the role of support staff, and RTI-MM program components that facilitated support staff engagement in the process of implementing MVA services.
  
  
  RESULTS
  We identified three key themes around interprofessional training and the role of support staff: "Training together is rare," "Support staff are crucial to practice change," and "Transparency, peers and champions."
  
  
  CONCLUSIONS
  We present lessons learned that may be transferrable to other clinic sites: engage site leadership in a commitment to interprofessional training; engage support staff as teachers and learners and in shared values and building professionalism.
  
  
  CONCLUSIONS
  This manuscript adds to what is known about how to employ interprofessional education and training to engage support staff in reproductive health services practice change initiatives. Lessons learned may provide guidance to clinical sites interested in interprofessional training, improving service delivery, or implementing new services.
authors.affiliation: Department of Medical Informatics and Clinical Epidemiology and Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR 97239, USA. darneyb@ohsu.edu
authors.forename: Blair G
authors.initials: BG
authors.lastname: Darney
authors.forename: Deborah
authors.initials: D
authors.lastname: VanDerhei
authors.forename: Marcia R
authors.initials: MR
authors.lastname: Weaver
authors.forename: Nancy G
authors.initials: NG
authors.lastname: Stevens
authors.forename: Sarah W
authors.initials: SW
authors.lastname: Prager
mesh_terms: D000022:Abortion, Spontaneous / Q000628:therapy*; D005194:Family Practice; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D011247:Pregnancy; D014619:Vacuum Curettage / Q000193:education*
keywords: Implementation; Miscarriage; Practice change; Support staff; Team training