Creating an Implementation Enhancement Plan for a Digital Patient Fall Prevention Platform Using the CFIR-ERIC Approach: A Qualitative Study

Alana Delaforce (), Jane Li, Melisa Grujovski, Joy Parkinson, Paula Richards, Michael Fahy, Norman Good and Rajiv Jayasena
Additional contact information
Alana Delaforce: Australian e-Health Research Centre, Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Herston, QLD 4029, Australia
Jane Li: Australian e-Health Research Centre, Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Westmead, NSW 2145, Australia
Melisa Grujovski: Nursing and Midwifery Services, Maitland Hospital, Hunter New England Local Health District, Maitland, NSW 2323, Australia
Joy Parkinson: Australian e-Health Research Centre, Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Herston, QLD 4029, Australia
Paula Richards: Nursing and Midwifery Services, Maitland Hospital, Hunter New England Local Health District, Maitland, NSW 2323, Australia
Michael Fahy: Nursing and Midwifery Services, Maitland Hospital, Hunter New England Local Health District, Maitland, NSW 2323, Australia
Norman Good: Australian e-Health Research Centre, Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Herston, QLD 4029, Australia
Rajiv Jayasena: Australian e-Health Research Centre, Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Parkville, VIC 3052, Australia

IJERPH, 2023, vol. 20, issue 5, 1-17

Abstract: (1) Background: Inpatient falls are a major cause of hospital-acquired complications (HAC) and inpatient harm. Interventions to prevent falls exist, but it is unclear which are most effective and what implementation strategies best support their use. This study uses existing implementation theory to develop an implementation enhancement plan to improve the uptake of a digital fall prevention workflow. (2) Methods: A qualitative approach using focus groups/interview included 12 participants across four inpatient wards, from a newly built, 300-bed rural referral hospital. Interviews were coded to the Consolidated Framework for Implementation Research (CFIR) and then converted to barrier and enabler statements using consensus agreement. Barriers and enablers were mapped to the Expert Recommendations for Implementing Change (ERIC) tool to develop an implementation enhancement plan. (3) Results: The most prevalent CFIR enablers included: relative advantage ( n = 12), access to knowledge and information ( n = 11), leadership engagement ( n = 9), patient needs and resources ( n = 8), cosmopolitanism ( n = 5), knowledge and beliefs about the intervention ( n = 5), self-efficacy ( n = 5) and formally appointed internal implementation leaders ( n = 5). Commonly mentioned CFIR barriers included: access to knowledge and information ( n = 11), available resources ( n = 8), compatibility ( n = 8), patient needs and resources ( n = 8), design quality and packaging ( n = 10), adaptability ( n = 7) and executing ( n = 7). After mapping the CFIR enablers and barriers to the ERIC tool, six clusters of interventions were revealed: train and educate stakeholders, utilize financial strategies, adapt and tailor to context, engage consumers, use evaluative and iterative strategies and develop stakeholder interrelations. (4) Conclusions: The enablers and barriers identified are similar to those described in the literature. Given there is close agreement between the ERIC consensus framework recommendations and the evidence, this approach will likely assist in enhancing the implementation of Rauland’s Concentric Care fall prevention platform and other similar workflow technologies that have the potential to disrupt team and organisational routines. The results of this study will provide a blueprint to enhance implementation that will be tested for effectiveness at a later stage.

Keywords: fall prevention; Consolidated Framework for Implementation Research; Expert Recommendations for Implementing Change; digital workflow; platform; enhancement plan (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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