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Wiley InterScience

Journal of the American Geriatrics Society

Journal of the American Geriatrics Society

Volume 52 Issue 11, Pages 1875 - 1882

Published Online: 26 Oct 2004

Journal compilation 2010 The American Geriatrics Society/Wiley Periodicals, Inc.



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Translating Research into Clinical Practice: Making Change Happen
Elizabeth H. Bradley, PhD * , Mark Schlesinger, PhD *‡ , Tashonna R. Webster, MPH * , Dorothy Baker, PhD, RNCS * , and Sharon K. Inouye, MD, MPH *†
From the Departments of  *Epidemiology and Public Health and  Internal Medicine, Yale School of Medicine, New Haven, Connecticut; and  Rutgers University, Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey.
Correspondence to  Elizabeth H. Bradley, PhD, Associate Professor, Department of Epidemiology and Public Health, Yale School of Medicine, 60 College Street, New Haven, CT 06520. E-mail: elizabeth.bradley@yale.edu

 This research was supported by grants from the Commonwealth Fund (20000484 and 990912) and Fan Fox and Leslie R. Samuels Foundation (99–351), the Retirement Research Foundation (99–361), and the Claude D. Pepper Older Americans Independence Center at Yale (P30AG21342). Drs. Bradley and Inouye are supported in part by the Patrick and Catherine Weldon Donaghue Medical Research Foundation (DF02-102 and DF98-105). Dr. Inouye is also supported in part by grants from the National Institute on Aging (R01AG12551 and K24AG00949).

Copyright © 2004 by the American Geriatrics Society
KEYWORDS
Hospital Elder Life Program • diffusion • clinical innovation • geriatrics

ABSTRACT

 

Objectives:

To describe the process of adoption of an evidence-based, multifaceted, innovative program into the hospital setting, with particular attention to issues that promoted or impeded its implementation. This study examined common challenges faced by hospitals implementing the Hospital Elder Life Program (HELP) and strategies used to address these challenges.

Design: Qualitative study design based on in-depth, open-ended telephone interviews.

Setting: Nine hospitals implementing HELP throughout the United States.

Participants: Thirty-two key staff members (physician, nursing, volunteer, and administrative staff) who were directly involved with the HELP implementation.

Measurements: Staff experiences implementing the program, including challenges and strategies they viewed as successful in overcoming challenges of implementation.

Results: Six common challenges faced hospital staff: (1) gaining internal support for the program despite differing requirements and goals of administration and clinical staff, (2) ensuring effective clinician leadership, (3) integrating with existing geriatric programs, (4) balancing program fidelity with hospital-specific circumstances, (5) documenting positive outcomes of the program despite limited resources for data collection and analysis, and (6) maintaining the momentum of implementation in the face of unrealistic time frames and limited resources. Strategies perceived to be successful in addressing each challenge are described.

Conclusion: Translating research into clinical practice is challenging for staff across disciplines. Developing strategies to address common challenges identified in this study may facilitate the adoption of innovative programs within healthcare organizations.


DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1532-5415.2004.52510.x About DOI

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