Integrating CFIR-ERIC and e-Delphi Methods to Increase Telegeriatrics Uptake.

Background and Objectives Participatory implementation methods are needed in geriatric health care to improve care and services for a growing population of older adults. We describe an efficient participatory approach to improve uptake of Geriatric Research Education and Clinical Center (GRECC) Conn...

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Published in:Gerontologist Vol. 63; no. 3; pp. 545 - 558
Main Authors: Kernan, Laura M, Dryden, Eileen M, Nearing, Kathryn, Kennedy, Meaghan A, Hung, Will, Moo, Lauren, Pimentel, Camilla B
Format: Article
Published: Oxford University Press / USA Apr2023
Subjects:
Online Access:View this record in EBSCOhost
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      dt: Apr2023
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      pub: Oxford University Press / USA
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        atl: Integrating CFIR-ERIC and e-Delphi Methods to Increase Telegeriatrics Uptake.
      aug:
        au:
          Kernan, Laura M
          Dryden, Eileen M
          Nearing, Kathryn
          Kennedy, Meaghan A
          Hung, Will
          Moo, Lauren
          Pimentel, Camilla B
        affil:
          Center for Healthcare Organization and Implementation Research, Department of Veterans Affairs (VA) Bedford Healthcare System , Bedford, Massachusetts , USA
          Department of Orthopaedics, Dartmouth-Hitchcock Medical Center , Lebanon, New Hampshire , USA
          Eastern Colorado Geriatric Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center , Aurora, Colorado , USA
          Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus , Aurora, Colorado , USA
          New England Geriatric Research Education and Clinical Center, VA Bedford Healthcare System , Bedford, Massachusetts , USA
          Department of Family Medicine, Boston University School of Medicine , Boston, Massachusetts , USA
          Bronx Geriatric Research Education and Clinical Center, James J. Peters VA Medical Center , Bronx, New York , USA
          Department of Geriatrics and Palliative Medicine, Icahn School of Medicine , Mount Sinai , New York, New York , USA
          Department of Neurology, Harvard Medical School , Boston, Massachusetts , USA
          Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell , Lowell, Massachusetts , USA
      su:
        Rural conditions
        Medical care
        Interviewing
        Qualitative research
        Action research
        Veterans
        Conceptual structures
        Quality assurance
        Descriptive statistics
        Research funding
        Delphi method
        Telemedicine
      sug:
        subj:
          Rural conditions
          Medical care
          Interviewing
          Qualitative research
          Action research
          Veterans
          Administration of Veterans' Affairs
          Conceptual structures
          Quality assurance
          Descriptive statistics
          Research funding
          Delphi method
          Telemedicine
      keyword:
        Health care systems and management telehealth
        Implementation science
        Quality improvement
        Rural and urban issues
        Health care systems and management telehealth
        Implementation science
        Quality improvement
        Rural and urban issues
      ab: Background and Objectives Participatory implementation methods are needed in geriatric health care to improve care and services for a growing population of older adults. We describe an efficient participatory approach to improve uptake of Geriatric Research Education and Clinical Center (GRECC) Connect, a national geriatrics outpatient consultation service using telehealth technology to connect geriatric specialists to rural, older veterans though community-based clinics. Research Design and Methods We designed a three-phase participatory method to identify high-priority implementation strategies to support the uptake of GRECC Connect. We used the Consolidated Framework for Implementation Research-Expert Recommendations for Implementing Change (CFIR-ERIC) Strategy Matching Tool to derive expert-recommended implementation strategies informed by qualitative interviews with both GRECC Connect staff and clinicians at community-based clinics. We engaged expert panelists in a participatory two-step modified e-Delphi process using confidential surveys and discussion to prioritize strategies nationally. Results Qualitative interviews revealed barriers, facilitators, and recommendations for program uptake. Many strategies recommended by CFIR-ERIC addressed multiple barriers but needed to be tailored to our specific context. In our two-step e-Delphi process, expert panelists shared previous experience with the strategies presented, views on the importance and feasibility of each, and arrived at a consensus about which strategies to prioritize nationally. Discussion and Implications We demonstrate the feasibility and benefits of engaging subject matter experts to identify strategies to be tested on a national level. Future considerations include weighting of survey responses, accounting for regional differences, and sensitivity of Likert scales used in the e-Delphi process.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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