Interorganizational Context When Implementing Multisector Partnered Programs: A Qualitative Analysis of Veteran...

Area of Science:

• Health Services Research
• Implementation Science
• Gerontology

Background:

• Increasing number of Veterans require Long Term Services and Supports (LTSS).
• Veterans Health Administration (VHA) is transitioning from institutional care to Home and Community Based Services (HCBS).
• Veteran-Directed Care (VDC) is a key HCBS program involving VHA and external agencies.

Purpose of the Study:

• To identify factors influencing the interorganizational implementation context of the VDC program.
• To understand barriers and facilitators in multi-sector collaborations for VDC.

Main Methods:

• Qualitative study using constructs from the Consolidated Framework for Implementation Research (CFIR).
• Interviews conducted with VDC coordinators from seven VHA-ADNA partnerships.
• Analysis of factors affecting the establishment and implementation of VDC.

Main Results:

• Eight CFIR determinants (e.g., evidence strength, adaptability, champions) were consistently observed across VHA and ADNA settings.
• Three CFIR determinants (available resources, implementation climate, relative priority) showed significant variation between VHA and ADNA.
• Interorganizational context critically influences multi-sector collaborations like VDC.

Conclusions:

• Understanding interorganizational dynamics is crucial for effective VDC implementation and scaling.
• Tailoring implementation strategies to address varying resources and priorities between collaborating sectors is essential.
• The findings provide insights for optimizing multi-sector collaborations in healthcare delivery.