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Nursing Implementation01:15

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An interdisciplinary team includes many healthcare professionals working together and utilizing their skills, knowledge, and expertise to provide holistic and quality patient care. Here are a few more healthcare professionals.
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Implementing transitional care in skilled nursing facilities: Evaluation of a learning collaborative.

Mark Toles1, Alesia Frerichs2, Jennifer Leeman1

  • 1The University of North Carolina at Chapel Hill, Carrington Hall, Campus Box #7460, Chapel Hill, NC 27599-7460, United States.

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|June 5, 2021
PubMed
Summary
This summary is machine-generated.

This study evaluated a learning collaborative to implement transitional care in skilled nursing facilities (SNFs). The program showed good reach, adoption, and fidelity, proving feasible even during the COVID-19 pandemic.

Keywords:
Implementation scienceQuality improvementSkilled nursing facilitiesTransitional care

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Area of Science:

  • Implementation Science
  • Healthcare Management
  • Public Health

Background:

  • Transitional care interventions are crucial for improving patient outcomes after hospital discharge.
  • Skilled nursing facilities (SNFs) play a vital role in post-acute care.
  • Effective implementation strategies are needed to ensure evidence-based interventions are adopted in real-world settings.

Purpose of the Study:

  • To evaluate the effectiveness of a learning collaborative designed to implement a transitional care intervention in SNFs.
  • To assess the reach, adoption, implementation fidelity, and maintenance of the intervention using the RE-AIM framework.

Main Methods:

  • A learning collaborative model was used to deliver implementation strategies.
  • The RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework guided the outcome evaluation.
  • Data were collected on patient reach, SNF adoption rates, and fidelity to intervention components.

Main Results:

  • The intervention reached 550 SNF patients.
  • Three out of four interested SNFs adopted the intervention.
  • Moderate to high fidelity (64-93%) was observed in the delivery of key transitional care components.
  • The protocol demonstrated feasibility and value during the COVID-19 pandemic.

Conclusions:

  • A learning collaborative is a viable strategy for implementing transitional care interventions in SNFs.
  • The intervention showed promising results in terms of reach, adoption, and fidelity, even under challenging circumstances.
  • The findings support the feasibility and value of structured implementation support for healthcare innovations.