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Sustaining Clinical Programs During Difficult Economic Times: A Case Series from the Hospital Elder Life Program
Author(s) -
SteelFisher Gillian K.,
Martin Lauren A.,
Dowal Sarah L.,
Inouye Sharon K.
Publication year - 2011
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2011.03585.x
Subject(s) - medicine , qualitative research , focus group , health care , nursing , medical education , marketing , business , social science , sociology , economics , economic growth
Objectives To explore strategies used by clinical programs to justify operations to decision‐makers using the example of the Hospital Elder Life Program ( HELP ), an evidence‐based, cost‐effective program to improve care for hospitalized older adults. Design Qualitative study design using 62 in‐depth, semistructured interviews conducted with HELP staff members and hospital administrators between September 2008 and August 2009. Setting Nineteen HELP sites in hospitals across the United States and Canada that had been recruiting patients for at least 6 months. Participants HELP staff and hospital administrators. Measurements Participant experiences sustaining the program in the face of actual or perceived financial threats, with a focus on factors they believe are effective in justifying the program to decision‐makers in the hospital or health system. Results Using the constant comparative method, a standard qualitative analysis technique, three major themes were identified across interviews. Each focuses on a strategy for successfully justifying the program and securing funds for continued operations: interact meaningfully with decision‐makers, including formal presentations that showcase operational successes and informal means that highlight the benefits of HELP to the hospital or health system; document day‐to‐day, operational successes in metrics that resonate with decision‐maker priorities; and garner support from influential hospital staff that feed into administrative decision‐making, particularly nurses and physicians. Conclusion As clinical programs face financially challenging times, it is important to find effective ways to justify their operations to decision‐makers. Strategies described here may help clinically effective and cost‐effective programs sustain themselves and thus may help improve care in their institutions.