Adapting a quality improvement collaborative to a new national context: a co-design and feasibility study to improve dementia care in Ireland.
Adaptation
Audit and feedback
Co-design
Feasibility
Quality improvement collaborative
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
04 Oct 2023
04 Oct 2023
Historique:
received:
19
05
2023
accepted:
11
09
2023
medline:
5
10
2023
pubmed:
4
10
2023
entrez:
3
10
2023
Statut:
epublish
Résumé
Adaptation seeks to increase intervention fit with context, an important influence upon implementation. People with dementia in acute hospitals in Ireland do not routinely receive best care. To improve care in Ireland, we sought to adapt an existing quality improvement collaborative, to support the improvement capabilities of recipients of feedback from the Irish National Audit of Dementia. The study followed a staged process to co-design adaptations to reflect contextual differences between the English and the Irish healthcare systems, and to explore feasibility of the adapted Quality Improvement Collaborative in Ireland. We used co-design group meetings involving dementia clinicians from three hospitals, delivered the intervention virtually and interviewed healthcare workers from seven hospitals to adapt and explore the fidelity, affective response and reported appropriateness of the intervention. The intervention required adaptation to reflect differences in strategic intention, ways of working and hospital social structures. There was evidence that the adapted intervention generated a positive affective response, was perceived as appropriate and led to fidelity of receipt and response. We describe implications for the adaptation of interventions to increase participants' quality improvement capabilities and highlight the importance of socio-adaptive work. We propose further work to explore antecedents of senior positional leader engagement, to describe the delivery of intra-participant behaviour change techniques and to adapt the intervention to other clinical domains.
Sections du résumé
BACKGROUND
BACKGROUND
Adaptation seeks to increase intervention fit with context, an important influence upon implementation. People with dementia in acute hospitals in Ireland do not routinely receive best care. To improve care in Ireland, we sought to adapt an existing quality improvement collaborative, to support the improvement capabilities of recipients of feedback from the Irish National Audit of Dementia.
METHODS
METHODS
The study followed a staged process to co-design adaptations to reflect contextual differences between the English and the Irish healthcare systems, and to explore feasibility of the adapted Quality Improvement Collaborative in Ireland. We used co-design group meetings involving dementia clinicians from three hospitals, delivered the intervention virtually and interviewed healthcare workers from seven hospitals to adapt and explore the fidelity, affective response and reported appropriateness of the intervention.
RESULTS
RESULTS
The intervention required adaptation to reflect differences in strategic intention, ways of working and hospital social structures. There was evidence that the adapted intervention generated a positive affective response, was perceived as appropriate and led to fidelity of receipt and response.
CONCLUSION
CONCLUSIONS
We describe implications for the adaptation of interventions to increase participants' quality improvement capabilities and highlight the importance of socio-adaptive work. We propose further work to explore antecedents of senior positional leader engagement, to describe the delivery of intra-participant behaviour change techniques and to adapt the intervention to other clinical domains.
Identifiants
pubmed: 37789348
doi: 10.1186/s12913-023-10019-3
pii: 10.1186/s12913-023-10019-3
pmc: PMC10548569
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1056Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
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