Identifying Factors Affecting the Sustainability of the STAR-VA Program in the Veterans Health Administration.
Background and Objectives Sustained implementation of new programs in complex care systems like nursing homes is challenging. This prospective qualitative evaluation examined factors affecting the sustainability of the Staff Training in Assisted Living Residences in Veterans Health Administration (S...
| Publicado en: | Gerontologist Vol. 63; no. 3; pp. 577 - 589 |
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| Autores principales: | , , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Apr2023
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=162734664&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 162734664 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00169013 GET jtl: Gerontologist issn: 00169013 maglogo: N pubinfo: dt: Apr2023 vid: 63 iid: 3 pid: 622 pub: Oxford University Press / USA artinfo: ui: 162734664 10.1093/geront/gnac090 ppf: 577 ppct: 12 formats: tig: atl: Identifying Factors Affecting the Sustainability of the STAR-VA Program in the Veterans Health Administration. aug: au: Adjognon, Omonyêlé L Sullivan, Jennifer L Pendergast, Jacquelyn Wray, Laura O Curyto, Kimberly affil: Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System , Boston, Massachusetts , USA Center of Innovation in Long-Term Services and Supports (LTSS COIN), VA Providence Healthcare System , Providence, Rhode Island , USA Department of Health Services, Policy and Practice, Brown University School of Public Health , Providence, Rhode Island , USA VA Center for Integrated Health (CIH), VA Western New York Healthcare System , Buffalo, New York , USA VA Center for Integrated Health (CIH), VA Western New York Healthcare System , Batavia, New York , USA su: United States. Dept. of Veterans Affairs Interviewing Congregate housing Human services programs Qualitative research Personnel management Research methodology Conceptual structures Research funding Descriptive statistics Data analysis software Medical care of veterans Longitudinal method sug: subj: Interviewing Congregate housing Human services programs Qualitative research Personnel management United States. Dept. of Veterans Affairs Community care facilities for the elderly Continuing Care Retirement Communities Assisted Living Facilities for the Elderly Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs) Human Resources Consulting Services Administration of Veterans' Affairs Research methodology Conceptual structures Research funding Descriptive statistics Data analysis software Medical care of veterans Longitudinal method keyword: Determinants Implementation science Nursing homes Determinants Implementation science Nursing homes ab: Background and Objectives Sustained implementation of new programs in complex care systems like nursing homes is challenging. This prospective qualitative evaluation examined factors affecting the sustainability of the Staff Training in Assisted Living Residences in Veterans Health Administration (STAR-VA) program in Veterans Health Administration (VA) Community Living Centers (CLC, i.e. nursing homes). STAR-VA is an evidence-based interdisciplinary, resident-centered, behavioral approach for managing distress behaviors in dementia. Evaluation Design and Methods In 2019, we conducted 39 semistructured phone interviews with STAR-VA key informants across 20 CLCs. We identified a priori themes based on the Organizational Memory Framework, which includes 7 Knowledge Reservoirs (KRs): people, routines, artifacts, relationships, organizational information space, culture, and structure. We conducted content-directed analysis of transcripts to identify factors to program sustainment. Results We identified 9 sustainment facilitators across KRs: engaged site leaders and champions, regular meetings and trainings, written documentation and resources, regular and open communication, available educational tools (e.g. handouts and posters), adequate spaces, leadership support on many levels, staff buy-in across disciplines, and staff competencies and recognition. Ten barriers across KRs included: staffing concerns, inconsistent/inefficient routines, inconsistent documentation, lack of written policies, communication gaps, nonstandardized use of tools, constraints with meeting spaces and regulations on posting information, limited leadership support, division among staff, and missing performance expectations. Discussion and Implications Findings inform tailored strategies for optimizing STAR-VA program sustainment in CLCs, including the development of a sustained implementation guide, implementation resources, regional communities of practice, and STAR-VA integration into national CLC quality improvement routines for team communication and problem-solving. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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