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Article

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

1
Australian e-Health Research Centre, Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Herston, QLD 4029, Australia
2
Australian e-Health Research Centre, Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Westmead, NSW 2145, Australia
3
Nursing and Midwifery Services, Maitland Hospital, Hunter New England Local Health District, Maitland, NSW 2323, Australia
4
Australian e-Health Research Centre, Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Parkville, VIC 3052, Australia
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2023, 20(5), 3794; https://doi.org/10.3390/ijerph20053794
Submission received: 21 December 2022 / Revised: 9 February 2023 / Accepted: 18 February 2023 / Published: 21 February 2023
(This article belongs to the Special Issue Evidence-Based Practice in Health Service Systems)

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 fall prevention; Consolidated Framework for Implementation Research; Expert Recommendations for Implementing Change; digital workflow; platform; enhancement plan

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MDPI and ACS Style

Delaforce, A.; Li, J.; Grujovski, M.; Parkinson, J.; Richards, P.; Fahy, M.; Good, N.; Jayasena, R. Creating an Implementation Enhancement Plan for a Digital Patient Fall Prevention Platform Using the CFIR-ERIC Approach: A Qualitative Study. Int. J. Environ. Res. Public Health 2023, 20, 3794. https://doi.org/10.3390/ijerph20053794

AMA Style

Delaforce A, Li J, Grujovski M, Parkinson J, Richards P, Fahy M, Good N, Jayasena R. Creating an Implementation Enhancement Plan for a Digital Patient Fall Prevention Platform Using the CFIR-ERIC Approach: A Qualitative Study. International Journal of Environmental Research and Public Health. 2023; 20(5):3794. https://doi.org/10.3390/ijerph20053794

Chicago/Turabian Style

Delaforce, Alana, Jane Li, Melisa Grujovski, Joy Parkinson, Paula Richards, Michael Fahy, Norman Good, and Rajiv Jayasena. 2023. "Creating an Implementation Enhancement Plan for a Digital Patient Fall Prevention Platform Using the CFIR-ERIC Approach: A Qualitative Study" International Journal of Environmental Research and Public Health 20, no. 5: 3794. https://doi.org/10.3390/ijerph20053794

APA Style

Delaforce, A., Li, J., Grujovski, M., Parkinson, J., Richards, P., Fahy, M., Good, N., & Jayasena, R. (2023). Creating an Implementation Enhancement Plan for a Digital Patient Fall Prevention Platform Using the CFIR-ERIC Approach: A Qualitative Study. International Journal of Environmental Research and Public Health, 20(5), 3794. https://doi.org/10.3390/ijerph20053794

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