Adaptations to relational facilitation for two national care coordination programs during COVID-19

Area of Science:

• Implementation Science
• Healthcare Management
• Public Health

Background:

• Adaptations to implementation strategies are crucial for scaling evidence-based practices.
• Tracking these adaptations is essential but often infrequent.
• Relational facilitation, a strategy to improve team communication and relationships, was implemented to support two Veterans Health Administration (VA) initiatives.

Purpose of the Study:

• To present a case study on a novel method for systematically tracking and reporting adaptations to relational facilitation during the COVID-19 pandemic.
• To assess the impact of these adaptations on the adoption and implementation of care coordination interventions within the VA.

Main Methods:

• Relational facilitation was implemented through in-person and virtual sessions, including coaching and surveys.
• Adaptations were tracked using a logic model, REDCap tool (based on FRAME and RE-AIM dimensions), and member checking.
• Adaptations were analyzed descriptively and thematically using matrix content analysis.

Main Results:

• Eight unique adaptations to relational facilitation were made due to COVID-19.
• Most adaptations (75%) involved changing the format of activities and were planned, external, and initiated by the implementation team.
• Adaptations primarily impacted adoption (75%) and implementation (25%) of the Care Coordination and Integrated Case Management (CC&ICM) and Transitions Nurse Program for Home Health Care (TNP-HHC) interventions.

Conclusions:

• Systematically tracking adaptations to relational facilitation during the pandemic enhanced engagement and adoption of VA care coordination interventions.
• The long-term impact of these adaptations on CC&ICM and TNP-HHC implementation will be monitored.