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Research Objectives
To explore variation in organizational and provider context and readiness for strategy
training implementation to inform the design of a trial in partnership with a national
rehabilitation corporation.
Design
Guided by the Consolidated Framework for Implementation Research (CFIR), we conducted
a two-phase cross-sectional descriptive study. Phase I examined variation in facility,
provider, and patient characteristics among 139 inpatient rehabilitation facilities.
We selected 30 facilities, oversampling those treating a higher proportion of patients
from racial and ethnic minorities, to participate in phase II. In phase II, Directors
of Therapy Operations (DTOs) and six providers (i.e., occupational, physical, and
speech therapy) from each facility were recruited to complete surveys and focus groups
to examine readiness for strategy training implementation. Using the findings and
the CFIR-Expert Recommendations for Implementing Change Matching Tool, we identified
a core set of implementation strategies to be examined in a future hybrid I effectiveness-implementation
pragmatic trial.
Setting
Inpatient rehabilitation facilities in the United States and Puerto Rico.
Participants
Phase I: 139 facilities; Phase II: 30 DTOs, 180 providers.
Interventions
N/A.
Main Outcome Measures
Organizational Readiness for Change Assessment, Inner Setting Questionnaire.
Results
The 139 facilities varied based on region, size, and patient socioeconomic status
indicators (phase I). Twenty-nine of 30 consented DTOs and 152 of 173 consented providers
completed all research activities (phase II). Providers identified variations in readiness
for change, leader behaviors and resources, implementation climate, and perceived
barriers and facilitators to implementing strategy training. Data informed a core
set of implementation strategies to address barriers.
Conclusions
Although facilities operate under the same national corporate infrastructure, context
related to readiness for implementation appears to vary.
Author(s) Disclosures
None.
Key Words
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Copyright
© 2022 Published by Elsevier Inc.
