After adoption: Sustaining the innovation - A case study of disseminating the Hospital Elder Life Program
After adoption: Sustaining the innovation - A case study of disseminating the Hospital Elder Life Program
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DOI：
10.1111/j.1532-5415.2005.53451.x
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发表时间：
2005-09-01
影响因子：
6.3
通讯作者：
Inouye, SK
中科院分区：
文献类型：
--
作者：
Bradley, EH;Webster, TR;Inouye, SK
目的：为了研究影响医院老年生命计划（HELP）传播可持续性的关键因素，作为一个以证据为基础的，多方面的，创新的计划，以改善住院老年人的护理为例，设计：纵向，定性研究2000年11月和2003年11月之间的102个深入访谈的基础上，每6个月在HELP实施。参与者：42名医院工作人员（医生，护理，志愿者，和行政人员）实施帮助，进行了102 interventions.MEASUREMENTS：工作人员的经验，维持该计划，包括挑战和战略，他们认为成功地解决这些挑战。在研究的13家医院中，10家在研究期结束时仍在维持HELP; 3家终止了该计划（24个月、12个月和6个月后）。关键因素被确定为影响该计划是否持续：临床领导的存在，使原始HELP协议适应当地医院情况和限制的能力和意愿，以及为HELP获得长期资源和资金的能力。认识到需要持续的临床领导和资金，以及不可避免的修改，以维持创新计划，促进卫生服务研究人员、临床医生和政策制定者在将研究转化为实践的值得称赞的努力中实现更现实的目标和期望。
OBJECTIVES: To examine key factors that influence sustainability in the diffusion of the Hospital Elder Life Program ( HELP) as an example of an evidence-based, multifaceted, innovative program to improve care for hospitalized older adults.DESIGN: Longitudinal, qualitative study between November 2000 and November 2003 based on 102 in-depth interviews every 6 months during HELP implementation.SETTING: Thirteen hospitals implementing HELP.PARTICIPANTS: Forty-two hospital staff members ( physician, nursing, volunteer, and administrative staff) implementing HELP, conducted 102 interviews.MEASUREMENTS: Staff experiences sustaining the program, including challenges and strategies that they viewed as successful in addressing these challenges.RESULTS: Of the 13 hospitals studied, 10 were sustaining HELP at the end of the study period; three terminated the program (after 24 months, 12 months, and 6 months). Critical factors were identified as influencing whether the program was sustained: the presence of clinical leadership, the ability and willingness to adapt the original HELP protocols to local hospital circumstances and constraints, and the ability to obtain longer-term resources and funding for HELP.CONCLUSION: Recognizing the need for sustained clinical leadership and funding as well as the inevitable modifications required to sustain innovative programs can promote more-realistic goals and expectations for health services researchers, clinicians, and policy makers in their laudable efforts to translate research into practice.