Applying the consolidated framework for implementation research to evaluate the community rapid intervention service

Area of Science:

• Healthcare services research
• Implementation science
• Community health interventions

Background:

• The Community Rapid Intervention Service (CRIS), established in 2019, aims to prevent hospital admissions by providing rapid, in-home care for sub-acute medical needs.
• CRIS offers a response within two hours to patients in their usual residence, enhancing community-based healthcare delivery.

Purpose of the Study:

• To evaluate the implementation of the CRIS, identifying key challenges and facilitators.
• To inform future service development, optimize patient care, and share learnings for similar community intervention services.

Main Methods:

• The Consolidated Framework for Implementation Research (CFIR) guided the evaluation methodology.
• Semi-structured interviews were conducted with healthcare leaders and clinicians interfacing with CRIS.
• Two Community of Practice meetings gathered stakeholder perspectives to triangulate findings.

Main Results:

• Three themes emerged: contextual factors (e.g., COVID-19 pandemic, service expansion), service identity, and navigating complexity.
• Service adaptability presented both implementation facilitators and challenges.
• Participants suggested improvements for the existing CRIS model.

Conclusions:

• The CRIS may require redefinition, particularly regarding its integration with acute, primary, community, and social services.
• Utilizing the CFIR framework effectively identified facilitators and challenges impacting CRIS implementation.
• Clarity in service interfaces is crucial for optimizing the CRIS model and its impact on patient care.