Hospital In Home: Evaluating Need and Readiness for Implementation (HENRI) in the Department of Veterans Affairs: protocol for a mixed-methods evaluation and participatory implementation planning study
Abstract Background and objectives The Department of Veterans Affairs (VA) Hospital-In-Home (HIH) program delivers patient-centered, acute-level hospital care at home. Compared to inpatient care, HIH has demonstrated improved patient safety, effectiveness, and patient and caregiver satisfaction. The...
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| Format: | Article |
| Language: | English |
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BMC
2022-08-01
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| Series: | Implementation Science Communications |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43058-022-00338-7 |
| _version_ | 1811297531022278656 |
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| author | Jennifer L. Sullivan Reza Yousefi-Nooraie Derek D’Arcy Adele Levine Lindsey Zimmerman Marlena H. Shin Emily Franzosa William Hung Orna Intrator |
| author_facet | Jennifer L. Sullivan Reza Yousefi-Nooraie Derek D’Arcy Adele Levine Lindsey Zimmerman Marlena H. Shin Emily Franzosa William Hung Orna Intrator |
| author_sort | Jennifer L. Sullivan |
| collection | DOAJ |
| description | Abstract Background and objectives The Department of Veterans Affairs (VA) Hospital-In-Home (HIH) program delivers patient-centered, acute-level hospital care at home. Compared to inpatient care, HIH has demonstrated improved patient safety, effectiveness, and patient and caregiver satisfaction. The VA Office of Geriatrics & Extended Care (GEC) has supported the development of 12 HIH program sites nationally, yet adoption in VA remains modest, and questions remain regarding optimal implementation practices to extend reach and adaptability of this innovation. Guided by theoretical and procedural implementation science frameworks, this study aims to systematically gather evidence from the 12 HIH programs and to develop a participatory approach to engage stakeholders, assess readiness, and develop/adapt implementation strategies and evaluation metrics. Research design and methods We propose a multi-phase concurrent triangulation design comprising of (1) qualitative interviews with key informants and document review, (2) quantitative evaluation of effectiveness outcomes, and (3) mixed-methods synthesis and adaptation of a Reach Effectiveness Adoption Implementation Maintenance (RE-AIM)-guided conceptual framework. Results The prospective phase will involve a participatory process of identifying stakeholders (leadership, HIH staff, veterans, and caregivers), engaging in planning meetings informed by implementation mapping, and developing implementation logic models and blueprints. The process will be assessed using a mixed-methods approach through participant observation and document review. Discussion and implication This study will support the continued spread of HIH programs, generate a catalog of HIH implementation evidence, and create implementation tools and infrastructure for future HIH development. The multi-phase nature of informing prospective planning with retrospective analysis is consistent with the Learning Health System framework. |
| first_indexed | 2024-04-13T06:05:45Z |
| format | Article |
| id | doaj.art-0ab8c4fa29234008919ccadc31431daa |
| institution | Directory Open Access Journal |
| issn | 2662-2211 |
| language | English |
| last_indexed | 2024-04-13T06:05:45Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Implementation Science Communications |
| spelling | doaj.art-0ab8c4fa29234008919ccadc31431daa2022-12-22T02:59:15ZengBMCImplementation Science Communications2662-22112022-08-013111010.1186/s43058-022-00338-7Hospital In Home: Evaluating Need and Readiness for Implementation (HENRI) in the Department of Veterans Affairs: protocol for a mixed-methods evaluation and participatory implementation planning studyJennifer L. Sullivan0Reza Yousefi-Nooraie1Derek D’Arcy2Adele Levine3Lindsey Zimmerman4Marlena H. Shin5Emily Franzosa6William Hung7Orna Intrator8Center for Innovation in Long Term Service and Supports, Providence VA Healthcare SystemDepartment of Public Health Science, University of RochesterVA Finger Lakes Healthcare SystemDepartment of Health Law Policy and Management, Boston University School of Public HealthOffice of Mental Health and Suicide Prevention, National Center for PTSDCenter for Healthcare Organization and Implementation Research, VA Boston Healthcare SystemGeriatric Research, Education and Clinical Center, James J. Peters VA Medical Center, Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount SinaiGeriatric Research, Education and Clinical Center, James J. Peters VA Medical Center, Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount SinaiDepartment of Public Health Science, University of RochesterAbstract Background and objectives The Department of Veterans Affairs (VA) Hospital-In-Home (HIH) program delivers patient-centered, acute-level hospital care at home. Compared to inpatient care, HIH has demonstrated improved patient safety, effectiveness, and patient and caregiver satisfaction. The VA Office of Geriatrics & Extended Care (GEC) has supported the development of 12 HIH program sites nationally, yet adoption in VA remains modest, and questions remain regarding optimal implementation practices to extend reach and adaptability of this innovation. Guided by theoretical and procedural implementation science frameworks, this study aims to systematically gather evidence from the 12 HIH programs and to develop a participatory approach to engage stakeholders, assess readiness, and develop/adapt implementation strategies and evaluation metrics. Research design and methods We propose a multi-phase concurrent triangulation design comprising of (1) qualitative interviews with key informants and document review, (2) quantitative evaluation of effectiveness outcomes, and (3) mixed-methods synthesis and adaptation of a Reach Effectiveness Adoption Implementation Maintenance (RE-AIM)-guided conceptual framework. Results The prospective phase will involve a participatory process of identifying stakeholders (leadership, HIH staff, veterans, and caregivers), engaging in planning meetings informed by implementation mapping, and developing implementation logic models and blueprints. The process will be assessed using a mixed-methods approach through participant observation and document review. Discussion and implication This study will support the continued spread of HIH programs, generate a catalog of HIH implementation evidence, and create implementation tools and infrastructure for future HIH development. The multi-phase nature of informing prospective planning with retrospective analysis is consistent with the Learning Health System framework.https://doi.org/10.1186/s43058-022-00338-7Hospital at HomeVeteransHome careOlder adultsInnovation |
| spellingShingle | Jennifer L. Sullivan Reza Yousefi-Nooraie Derek D’Arcy Adele Levine Lindsey Zimmerman Marlena H. Shin Emily Franzosa William Hung Orna Intrator Hospital In Home: Evaluating Need and Readiness for Implementation (HENRI) in the Department of Veterans Affairs: protocol for a mixed-methods evaluation and participatory implementation planning study Implementation Science Communications Hospital at Home Veterans Home care Older adults Innovation |
| title | Hospital In Home: Evaluating Need and Readiness for Implementation (HENRI) in the Department of Veterans Affairs: protocol for a mixed-methods evaluation and participatory implementation planning study |
| title_full | Hospital In Home: Evaluating Need and Readiness for Implementation (HENRI) in the Department of Veterans Affairs: protocol for a mixed-methods evaluation and participatory implementation planning study |
| title_fullStr | Hospital In Home: Evaluating Need and Readiness for Implementation (HENRI) in the Department of Veterans Affairs: protocol for a mixed-methods evaluation and participatory implementation planning study |
| title_full_unstemmed | Hospital In Home: Evaluating Need and Readiness for Implementation (HENRI) in the Department of Veterans Affairs: protocol for a mixed-methods evaluation and participatory implementation planning study |
| title_short | Hospital In Home: Evaluating Need and Readiness for Implementation (HENRI) in the Department of Veterans Affairs: protocol for a mixed-methods evaluation and participatory implementation planning study |
| title_sort | hospital in home evaluating need and readiness for implementation henri in the department of veterans affairs protocol for a mixed methods evaluation and participatory implementation planning study |
| topic | Hospital at Home Veterans Home care Older adults Innovation |
| url | https://doi.org/10.1186/s43058-022-00338-7 |
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