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Pre‐Implementation of the Age‐Friendly Health Systems Evidence‐Based 4Ms Framework in a Multi‐State Convenient Care Practice
Author(s) -
Dolansky Mary A.,
Pohnert Anne,
Ball Sarah,
McCormack Mary,
Hughes Robin,
Pino Lilia
Publication year - 2021
Publication title -
worldviews on evidence‐based nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.052
H-Index - 49
eISSN - 1741-6787
pISSN - 1545-102X
DOI - 10.1111/wvn.12498
Subject(s) - implementation research , workflow , health care , health informatics , process management , benchmarking , quality management , stakeholder , focus group , medicine , computer science , nursing , psychological intervention , management system , operations management , engineering , public health , database , business , public relations , marketing , political science , economics , economic growth
Background Quality issues in the delivery of healthcare services to older adults and changes in societal demographics call for a social movement to improve the care of older adults in a variety of healthcare settings, including ambulatory care and convenient care clinics. Aims To describe the pre‐implementation phase to integrate the Age‐Friendly Health Systems (AFHS) 4Ms (i.e., What Matters, Medication, Mentation, and Mobility) Framework in 1,100 MinuteClinics (the retail medical clinic of CVS Health) using the Consolidated Framework for Implementation Research (CFIR) and RE‐AIM (an evaluation implementation framework). Methods The CFIR and RE‐AIM models guided data collection. Data were collected from all stakeholders (patients, healthcare providers, managers, educators, informatics staff, communications staff, and implementation consultants) via observations, surveys, interviews, focus groups, organizational readiness assessment, stakeholder assessment, and workflow mapping during a 15‐month period to identify potential barriers, facilitators, and other opportunities for implementation. Results The CFIR and RE‐AIM implementation frameworks provided a comprehensive approach to guide the pre‐implementation phase of the AFHS 4Ms Framework at the MinuteClinic. The baseline assessments guided by the CFIR revealed important insights in the choice of implementation strategies that were developed and tested in the pre‐implementation phase, and the RE‐AIM guided meaningful components to the development of the logic model. Linking Action to Evidence As more healthcare systems integrate the AFHS 4Ms Framework, the approach reported in this quality improvement project can be used in other settings to facilitate a comprehensive implementation.