Strengthening Dementia Screening Through Implementation Science and Learning Health Systems

Over the past year, Tufts CTSI partnered with Tufts Medicine Behavioral Health to support the implementation of dementia screening in primary care, with a focus on strengthening the system’s capacity to learn from real-world practice. This reflects Tufts CTSI’s role in applying implementation science to bridge research, clinical operations, and continuous improvement within a learning health system. Tufts CTSI worked with Behavioral Health leaders on implementation-focused evaluation and planning related to the Centers for Medicare & Medicaid Services’ GUIDE dementia care model.

 

The team developed an implementation research logic model that articulated key determinants of implementation, including workflow complexity, readiness for change, reimbursement constraints, and provider and caregiver engagement. The logic model also specified implementation strategies related to reach, adoption, fidelity, and maintenance. Although Tufts Medicine chose not to move forward with GUIDE, this work engaged clinical and operational stakeholders in an assessment of feasibility and implementation readiness, strengthening the system’s foundation for future dementia care initiatives.

 

Building on this, Tufts CTSI is partnering with Behavioral Health on the Davos Alzheimer’s Collaborative Healthcare System Preparedness Early Detection Fellowship Expansion. This initiative aims to pilot an early dementia screening program across five sites, refine implementation strategies based on real-world experience, and generate mixed-methods data to inform sustainability. Tufts CTSI supported the application by introducing implementation science framing and is currently working to translate that framing into a practical implementation plan.

 

Tufts CTSI is currently focusing on workflow mapping, identification of core components of dementia screening, planning for site-specific adaptations, and aligning screening processes with existing primary care roles. We are also supporting Behavioral Health in planning for the collection of implementation outcomes required by the grant, with an emphasis on using data to guide learning and improvement.