In healthcare settings, system and organization leaders often control the selection and design of implementation strategies even though frontline workers may have the most intimate understanding of the care delivery process, and factors that optimize and constrain evidence-based practice implementation within the local system. Innovation tournaments, a structured participatory design strategy to crowdsource ideas, are a promising approach to participatory design that may increase the effectiveness of implementation strategies by involving end users (i.e., clinicians). We utilized a system-wide innovation tournament to garner ideas from clinicians about how to enhance the use of evidence-based practices (EBPs) within a large public behavioral health system. Our innovation tournament occurred in three phases. First, we invited over 500 clinicians to share, through a web-based platform, their ideas regarding how their organizations could best support use of EBPs. Clinicians could rate and comment on ideas submitted by others. Second, submissions were judged by an expert panel (including behavioral scientists, system leaders, and payers) based on their rated enthusiasm for the idea. Third, we held a community-facing event during which the six clinicians who submitted winning ideas presented their strategies to 85 attendees representing a cross-section of clinicians and system and organizational leaders. We had a high rate of participation (12.3%), more than double the average rate of previous tournaments conducted in other settings (5%). A total of 65 ideas were submitted by 55 participants representing 38 organizations. The most common categories of ideas pertained to training (42%), financing and compensation (26%), clinician support and preparation tools (22%), and EBP-focused supervision (17%). The expert panel and clinicians differed on their ratings of the ideas, highlighting value of seeking input from multiple stakeholder groups when developing implementation strategies. Innovation tournaments are a useful and feasible methodology for engaging end users, system leaders, and behavioral scientists through a structured approach to developing implementation strategies. The process and resultant strategies engendered significant enthusiasm and engagement from participants at all levels of a healthcare system. Research is needed to compare the effectiveness of strategies developed through innovation tournaments to strategies developed through design approaches.

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临床医生众包挑战：使用参与式设计来制定实施策略

在医疗机构中，系统和组织负责人通常会控制实施策略的选择和设计，即使一线员工可能对护理交付过程以及在本地系统中优化和限制循证实践的因素也有最密切的了解。创新竞赛是一种结构化的参与设计策略，可以众包创意，是一种很有前途的参与设计方法，通过让最终用户（例如临床医生）参与进来，可以提高实施策略的有效性。我们利用系统范围的创新比赛来征询临床医生的意见，以了解如何在大型公共行为健康系统中加强循证实践（EBP）的使用。我们的创新比赛分为三个阶段。第一的，我们邀请了500多名临床医生通过基于Web的平台分享他们关于组织如何最好地支持EBP使用的想法。临床医生可以对其他人提出的想法进行评分和评论。其次，意见书由专家小组（包括行为科学家，系统负责人和付款人）根据他们对该构想的热情评估。第三，我们举行了一次面向社区的活动，在此期间，提交了获奖想法的六位临床医生向代表临床医生以及系统和组织负责人的85位与会者介绍了他们的策略。我们的参与率很高（12.3％），是以前在其他环境中进行的锦标赛平均率（5％）的两倍多。代表38个组织的55位参与者总共提交了65个想法。最常见的想法类别包括培训（42％），财务和补偿（26％），临床医生支持和准备工具（22％）以及以EBP为重点的监督（17％）。专家小组和临床医生对想法的评价不同，强调了在制定实施策略时从多个利益相关者团体中寻求意见的价值。创新锦标赛是一种通过结构化方法制定实施策略来吸引最终用户，系统领导者和行为科学家的有用且可行的方法。该过程和由此产生的策略引起了医疗系统各个级别参与者的极大热情和参与。需要进行研究以将通过创新竞赛开发的策略与通过设计方法开发的策略的有效性进行比较。