Importance of early consideration of scaling and sustainability for aging‐related care models: Case study of Hospital at Home.
For aging‐related research, there is a pressing need to attend to the dissemination and implementation of evidence‐based interventions. Some aging‐related interventions with established effectiveness may be poorly disseminated and implemented due to behavioral, organizational, payment, or other cons...
| Publicado en: | Journal of the American Geriatrics Society Vol. 72; no. 12; pp. 3647 - 3656 |
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| Autores principales: | , |
| Formato: | Artículo |
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Wiley-Blackwell
Dec2024
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| 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=181624005&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 181624005 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00028614 20Q jtl: Journal of the American Geriatrics Society issn: 00028614 maglogo: Y pubinfo: dt: Dec2024 vid: 72 iid: 12 pid: 480 pub: Wiley-Blackwell artinfo: ui: 181624005 10.1111/jgs.19042 ppf: 3647 ppct: 9 formats: tig: atl: Importance of early consideration of scaling and sustainability for aging‐related care models: Case study of Hospital at Home. aug: au: Siu, Albert L. Leff, Bruce affil: Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York New York,, USA Geriatrics Research, Education, and Clinical Center (GRECC) at the James J. Peters VA Medical Center, Bronx New York,, USA Division of Geriatric Medicine, Department of Medicine, Center for Transformative Geriatric Research, Johns Hopkins University School of Medicine, Baltimore Maryland,, USA su: Home care services Human services programs Geriatrics Leadership Psychological adaptation Aging Hospital emergency services Transitional care sug: subj: Home care services Human services programs Geriatrics Leadership Psychological adaptation Aging Offices of All Other Miscellaneous Health Practitioners Home Health Care Services Services for the Elderly and Persons with Disabilities Offices of all other health practitioners Hospital emergency services Transitional care keyword: adaptation model of care sustainability adaptation model of care sustainability ab: For aging‐related research, there is a pressing need to attend to the dissemination and implementation of evidence‐based interventions. Some aging‐related interventions with established effectiveness may be poorly disseminated and implemented due to behavioral, organizational, payment, or other constraints. To provide insight into the beginning to end process of translation and implementation, we present a case history of the three‐decade progression of Hospital at Home (HaH) now nearing national dissemination. We summarize research at various phases with particular attention to implementation considerations. Reviewing over three decades of HaH‐related research dating from initial discovery to translation and implementation, we found that the content and importance of different constructs (e.g., inner practice vs. outer environmental setting) and the choice of implementation strategies differed depending on implementation context (testing of effectiveness, scaling, or sustainability). Early effectiveness studies mostly examined implementation issues related to the intervention, the practice setting, and the individuals involved. However, explicit and early consideration of scale and sustainment was not the primary focus. For example, HaH program intake is primarily through hospital emergency departments (ED). Initial efforts would have benefited from incorporating strategies (e.g., incorporating ED leadership into program leadership) to address night and weekend admissions. Many regulatory barriers did not surface during initial considerations. Considering implementation issues late may contribute to delay in bringing discoveries to population impact. The experience with HaH suggests that scale and sustainability bear earlier consideration because barriers and facilitators to implementation are likely to be different in content and importance at different phases of implementation. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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