Harnessing Protocolized Adaptation in Dissemination: Successful Implementation and Sustainment of the Veterans Affairs Coordinated-Transitional Care Program in a Non-Veterans Affairs Hospital.
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| Title: | Harnessing Protocolized Adaptation in Dissemination: Successful Implementation and Sustainment of the Veterans Affairs Coordinated-Transitional Care Program in a Non-Veterans Affairs Hospital. |
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| Authors: | Kind, Amy J. H., Brenny‐Fitzpatrick, Maria, Leahy‐Gross, Kris, Mirr, Jacquelyn, Chapman, Elizabeth, Frey, Brooke, Houlahan, Beth |
| Source: | Journal of the American Geriatrics Society. Feb2016, Vol. 64 Issue 2, p409-416. 8p. 2 Diagrams, 2 Charts, 1 Graph. |
| Subjects: | United States. Dept. of Veterans Affairs, Patient aftercare, Inpatient care, Veterans' hospitals, Patient readmissions |
| Geographic Terms: | United States |
| Abstract: | The Department of Veterans Affairs (VA) Coordinated-Transitional Care (C-TraC) program is a low-cost transitional care program that uses hospital-based nurse case managers, inpatient team integration, and in-depth posthospital telephone contacts to support high-risk patients and their caregivers as they transition from hospital to community. The low-cost, primarily telephone-based C-TraC program reduced 30-day rehospitalizations by one-third, leading to significant cost savings at one VA hospital. Non-VA hospitals have expressed interest in launching C-TraC, but non-VA hospitals differ in important ways from VA hospitals, particularly in terms of context, culture, and resources. The objective of this project was to adapt C-TraC to the specific context of one non-VA setting using a modified Replicating Effective Programs (REP) implementation theory model and to test the feasibility of this protocolized implementation approach. The modified REP model uses a mentored phased-based implementation with intensive preimplementation activities and harnesses key local stakeholders to adapt processes and goals to local context. Using this protocolized implementation approach, an adapted C-TraC protocol was created and launched at the non- VA hospital in July 2013. In its first 16 months, C-TraC successfully enrolled 1,247 individuals with 3.2 full-time nurse case managers, achieving good fidelity for core protocol steps. C-TraC participants experienced a 30-day rehospitalization rate of 10.8%, compared with 16.6% for a contemporary comparison group of similar individuals for whom C-TraC was not available (n = 1,307) (P < .001). The new C-TraC program continues in operation. Use of a modified REP model to guide protocolized adaptation to local context resulted in a C-TraC program that was feasible and sustained in a real-world non- VA setting. A modified REP implementation framework may be an appropriate foundational step for other clinical programs seeking to harness protocolized adaptation in mentored dissemination activities. [ABSTRACT FROM AUTHOR] |
| Copyright of Journal of the American Geriatrics Society is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Text: Availability: 0 |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 113137118 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Harnessing Protocolized Adaptation in Dissemination: Successful Implementation and Sustainment of the Veterans Affairs Coordinated-Transitional Care Program in a Non-Veterans Affairs Hospital. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Kind%2C+Amy+J%2E+H%2E%22">Kind, Amy J. H.</searchLink><br /><searchLink fieldCode="AR" term="%22Brenny‐Fitzpatrick%2C+Maria%22">Brenny‐Fitzpatrick, Maria</searchLink><br /><searchLink fieldCode="AR" term="%22Leahy‐Gross%2C+Kris%22">Leahy‐Gross, Kris</searchLink><br /><searchLink fieldCode="AR" term="%22Mirr%2C+Jacquelyn%22">Mirr, Jacquelyn</searchLink><br /><searchLink fieldCode="AR" term="%22Chapman%2C+Elizabeth%22">Chapman, Elizabeth</searchLink><br /><searchLink fieldCode="AR" term="%22Frey%2C+Brooke%22">Frey, Brooke</searchLink><br /><searchLink fieldCode="AR" term="%22Houlahan%2C+Beth%22">Houlahan, Beth</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Journal+of+the+American+Geriatrics+Society%22">Journal of the American Geriatrics Society</searchLink>. Feb2016, Vol. 64 Issue 2, p409-416. 8p. 2 Diagrams, 2 Charts, 1 Graph. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22United+States%2E+Dept%2E+of+Veterans+Affairs%22">United States. Dept. of Veterans Affairs</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+aftercare%22">Patient aftercare</searchLink><br /><searchLink fieldCode="DE" term="%22Inpatient+care%22">Inpatient care</searchLink><br /><searchLink fieldCode="DE" term="%22Veterans'+hospitals%22">Veterans' hospitals</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+readmissions%22">Patient readmissions</searchLink> – Name: SubjectGeographic Label: Geographic Terms Group: Su Data: <searchLink fieldCode="DE" term="%22United+States%22">United States</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: The Department of Veterans Affairs (VA) Coordinated-Transitional Care (C-TraC) program is a low-cost transitional care program that uses hospital-based nurse case managers, inpatient team integration, and in-depth posthospital telephone contacts to support high-risk patients and their caregivers as they transition from hospital to community. The low-cost, primarily telephone-based C-TraC program reduced 30-day rehospitalizations by one-third, leading to significant cost savings at one VA hospital. Non-VA hospitals have expressed interest in launching C-TraC, but non-VA hospitals differ in important ways from VA hospitals, particularly in terms of context, culture, and resources. The objective of this project was to adapt C-TraC to the specific context of one non-VA setting using a modified Replicating Effective Programs (REP) implementation theory model and to test the feasibility of this protocolized implementation approach. The modified REP model uses a mentored phased-based implementation with intensive preimplementation activities and harnesses key local stakeholders to adapt processes and goals to local context. Using this protocolized implementation approach, an adapted C-TraC protocol was created and launched at the non- VA hospital in July 2013. In its first 16 months, C-TraC successfully enrolled 1,247 individuals with 3.2 full-time nurse case managers, achieving good fidelity for core protocol steps. C-TraC participants experienced a 30-day rehospitalization rate of 10.8%, compared with 16.6% for a contemporary comparison group of similar individuals for whom C-TraC was not available (n = 1,307) (P < .001). The new C-TraC program continues in operation. Use of a modified REP model to guide protocolized adaptation to local context resulted in a C-TraC program that was feasible and sustained in a real-world non- VA setting. A modified REP implementation framework may be an appropriate foundational step for other clinical programs seeking to harness protocolized adaptation in mentored dissemination activities. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Journal of the American Geriatrics Society is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/jgs.13935 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 8 StartPage: 409 Subjects: – SubjectFull: United States. Dept. of Veterans Affairs Type: general – SubjectFull: Patient aftercare Type: general – SubjectFull: Inpatient care Type: general – SubjectFull: Veterans' hospitals Type: general – SubjectFull: Patient readmissions Type: general – SubjectFull: United States Type: general Titles: – TitleFull: Harnessing Protocolized Adaptation in Dissemination: Successful Implementation and Sustainment of the Veterans Affairs Coordinated-Transitional Care Program in a Non-Veterans Affairs Hospital. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Kind, Amy J. H. – PersonEntity: Name: NameFull: Brenny‐Fitzpatrick, Maria – PersonEntity: Name: NameFull: Leahy‐Gross, Kris – PersonEntity: Name: NameFull: Mirr, Jacquelyn – PersonEntity: Name: NameFull: Chapman, Elizabeth – PersonEntity: Name: NameFull: Frey, Brooke – PersonEntity: Name: NameFull: Houlahan, Beth IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 02 Text: Feb2016 Type: published Y: 2016 Identifiers: – Type: issn-print Value: 00028614 Numbering: – Type: volume Value: 64 – Type: issue Value: 2 Titles: – TitleFull: Journal of the American Geriatrics Society Type: main |
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