Implementation fidelity of the Systems for Person-Centered Elder Care (SPEC): a process evaluation study

Area of Science:

• Gerontology
• Healthcare Management
• Health Informatics

Background:

• Investigated the Systems for Person-Centered Elder Care (SPEC) intervention, a technology-enhanced, multidisciplinary model for frail older adults in South Korean nursing homes.
• Focused on evaluating implementation fidelity and identifying moderating factors within a recently introduced formal long-term care system.

Purpose of the Study:

• To evaluate the implementation fidelity of the SPEC intervention.
• To identify factors that facilitate or hinder the successful implementation of person-centered elder care models.

Main Methods:

• Employed a mixed-methods process evaluation based on an evidence-based implementation fidelity framework.
• Collected quantitative data from logs, documentation, an ICT system, and questionnaires (April 2015-December 2016).
• Conducted qualitative analysis of semi-structured questionnaires and focus group interviews with multidisciplinary teams.

Main Results:

• The SPEC program achieved good implementation fidelity, with strong adherence across content, coverage, frequency, and duration.
• 60% of on-site coordinators reported positive impacts on needs assessment and resident care reporting systems.
• Facilitating factors included tailored strategies, quality assurance, and effective recruitment.

Conclusions:

• The effectiveness of the SPEC program is strongly linked to its high implementation fidelity.
• Key drivers of fidelity were tailored evidence-based interventions, facilitating strategies, and information and communications technology (ICT) support.
• Recommendations include larger implementation studies and development of more user-friendly ICT systems.