A codesigned fit‐for‐purpose implementation framework for aged care

Abstract

Rationale, Aims and Objectives: The field of implementation science is critical for embedding research evidence into healthcare practice, benefiting individuals, organizations, governments, and the broader community. Implementation science is messy and complex, underpinned by many theories and frameworks. Efficacious interventions for older people with multiple comorbidities exist, yet many lack effectiveness evaluation relevant to pragmatic implementation within aged care practice. This article outlines the conceptualization and development of an Implementation Framework for Aged Care (IFAC), fit-for-purpose for an aged care organization, Bolton Clarke, intent on embedding evidence into practice.Method: A four-stage process was adopted to (1) explore context and relevant literature to conceptualize the IFAC; (2) identify key elements for a draft IFAC;(3) expand elements and refine the draft in consultation with experts and (4) apply the IFAC to three existing projects, identifying key learnings. A checklist to operationalize the IFAC was then developed. Results:The IFAC is grounded in codesign principles and encapsulated by the implementation context, from a social, cultural and political perspective. The IFAC addresses the questions of (1) why do we need to change?; (2) what do we know?; (3) who will benefit?; (4) who will make the change?; ( 5) what strategies will be used?; and ( 6) what difference are we making? Three pilot projects: early adoption of a Wellness and Reablement approach; a care worker and virtual physiotherapist-led program to prevent falls; and a therapeutic horticulture program for residential communities, highlight learnings of applying the IFAC in practice. Conclusion:This fit-for-purpose IFAC was developed for a proactive and responsive aged care provider. The simplicity of the six-question IFAC is underpinned by substantial theoretical perspectives for its elements and their connections.

Risk Negotiation With People With Dementia: From Co-designed Paper Version to Implementation Preparation of an Electronic Conversation Tool

“…The lead researcher also worked with operational and frontline staff to identify responses for implementation preparation in line with an implementation checklist ( Meyer et al, 2022 ). Responses can be found in Table 2 for questions of: (1) why we need to change?…”

“…The wider aged care landscape and context was mapped by the research team, specifically to identify organizational and broader system factors that may influence implementation of the tool into practice. In line with the IFAC, an implementation planning checklist was utilized ( Meyer et al, 2022 ) to clarify:…”

“…Implementation of any tool into practice is complex, messy and predicated upon social relations and contextual factors ( Braithwaite et al, 2018 ; Sturmberg et al, 2021 ). To maximize the systematic uptake of a tool into practice, planning must be comprehensive, relevant, and adaptive ( Meyer et al, 2022 ). Numerous implementation frameworks exist but operationalizing the complex facets of implementation is challenging.…”

“…Numerous implementation frameworks exist but operationalizing the complex facets of implementation is challenging. The fit-for-purpose Implementation Framework for Aged Care (IFAC) is underpinned by Normalization Process Theory, focusing on how social processes are crucial to integrating implementation principles for change in practice ( Meyer et al, 2022 ). This paper describes the conversion of the original paper-based tool into electronic format, utilizing codesign principles, and preparation for implementation with the IFAC throughout a large Australian health and aged care service provider.…”

Assessing Older Community Members Using a Social Work Tool: Developing an Organizational Response

“… Adapted co-design framework (reprinted Figure 1 . Adapted co-design framework from Meyer et al (2022) . …”