Participatory Approach to Program Sustainment: Example From a Multisite National Geriatrics Telemedicine Program

Area of Science:

• Health Services Research
• Program Implementation Science
• Geriatric Healthcare Delivery

Background:

• Sustaining evidence-based programs in evolving healthcare settings is challenging.
• Large-scale program sustainment in diverse environments needs further study.
• GRECC Connect, a 19-site VA program, aimed to improve rural geriatric care access.

Purpose of the Study:

• To describe a novel, participatory 3-phase approach for identifying sustainment strategies.
• To illustrate the approach's application using the GRECC Connect program as a case study.
• To provide a framework for sustaining large-scale health programs in complex settings.

Main Methods:

• A 3-phase participatory approach involving 19 Veterans Health Administration (VA) hub sites.
• Phase 1: Program Sustainment Assessment Tool completion.
• Phase 2: Virtual retreat for knowledge exchange; Phase 3: Development of site-specific sustainment plans.

Main Results:

• High participation across all 19 sites.
• Sites identified specific barriers and facilitators to sustainment.
• Most sites found the participatory approach "very useful" for sustainment planning.

Conclusions:

• The approach provided a framework for peer learning and identifying local sustainment needs.
• The process was well-received and useful for planning sustainment journeys.
• This methodology offers a blueprint for sustaining programs across diverse healthcare networks.