Table 1.
| Determinants | Implementation strategy (theory) | Definition implementation strategy | Practical application whitin the implementation plan | Related actions in the implementation plan |
|---|---|---|---|---|
|
• Self-efficacy • Capable leadership |
• Modelling (Diffusion of Innovations Theory [33]) |
• Modelling: ‘Providing an appropriate model being reinforced for the desired action.’ | Falls prevention coordinator: A healthcare worker appointed by management who will coordinate the implementation process of a clinical practice guideline (CPG) and will act as a pioneer for falls prevention (i.e. sets examples of good practices for colleagues). The falls prevention coordinator is part of the falls prevention team and is accessible to all the staff at the residential aged care facility (RACF), residents, relatives and informal care givers. |
• Action 1.3. Establish a falls prevention team • Action 1.4. Involve local stakeholders • Action 2.1. Gain insight into the problem • Action 2.2. Identify gaps and existing policies • Action 3.1. Develop a vision and goals • Action 3.2. Create a positive culture • Action 3.3. Set priorities • Action 3.4. Acquire knowledge and skills • Action 4.1. Develop actions • Action 5.1. Execute actions • Action 6.1. Measure the results • Action 6.2: Evaluate • Action 6.3. Adjust actions • Action 7.1. Pursue sustainability |
|
• Team processes • Communication and influence • Cultural appropriateness • Feasibility |
• Participation (Diffusion of Innovations Theory [33]) • Tailoring (Trans-Theoretical Model [32]) |
• Participation: ‘Assuring high level engagement of the participants’ group in problem solving, decision making, and change activities; with highest level being control by the participants’ group.’ • Tailoring: ‘Matching the intervention or components to previously measured characteristics of the participant.’ |
Falls prevention team: A multidisciplinary team established by the falls prevention coordinator. They will support the falls prevention coordinator and ensure that all departments/wards of the RACF are involved. They are responsible for: 1) raising awareness about falls prevention among the staff of the RACF, residents, relatives, and informal care givers; 2) developing, executing, and sustaining a falls prevention policy based on the CPG, tailored to the context of the RACF taking into account their existing systems and structures; 3) actively communicating their decisions about the falls prevention policy to their own department and colleagues. |
• Action 1.4. Involve local stakeholders • Action 2.1. Gain insight into the problem • Action 2.2. Identify gaps and existing policies • Action 3.1. Develop a vision and goals • Action 3.2. Create a positive culture • Action 3.3. Set priorities • Action 3.4. Acquire knowledge and skills • Action 4.1. Develop actions • Action 5.1. Execute actions • Action 6.1. Measure the results • Action 6.2. Evaluate Actions • Action 6.3. Adjust actions • Action 7.1. Pursue sustainability |
|
• Cultural appropriateness • Priority of necessary change |
• Increasing stakeholders influence (Stakeholder Theory [31]) |
• Increasing stakeholders influence: ‘Increase stakeholder power, legitimacy, and urgency, often by forming coalitions and using community development and social action to change an organization’s policies.’ | Stakeholders involvement: From the start of the process, local stakeholders from in and outside the RACF (e.g. residents, relatives, volunteers) are asked by the falls prevention team to be actively involved in each step of the implementation plan. With each local stakeholder, the falls prevention team makes an agreement on how, the frequency, by whom, and when they will be contacted. |
• Action 1.4. Involve local stakeholders • Action 2.1. Gain insight into the problem • Action 2.2. Identify gaps and existing policies • Action 4.1. Develop actions • Action 6.3. Adjust actions |
|
• Domain knowledge • Skills • Awareness and familiarity with the recommendation • Education system |
• Active learning (Social Cognitive Theory [34]) • Guided practice (Social Cognitive Theory [34]) • Feedback (Social Cognitive Theory [34]) |
• Active learning: ‘Encouraging learning from goal-driven and activity-based experience.’ • Guided practice: ‘Prompting individuals to rehearse and repeat the behaviour various times, discuss the experience, and provide feedback.’ • Feedback: ‘Giving information to individuals and environmental agents regarding the extent to which they are accomplishing learning or performance, or the extent to which performance is having an impact.’ |
Interactive educational sessions: The falls prevention team (in cooperation with the department head and management) organises and gives an interactive education session (e.g. asking questions, sharing experiences) concerning the CPG on falls prevention in RACFs and provides hands-on training and feedback on how to perform the multifactorial assessment and interventions. |
• Action 3.4. Acquire knowledge and skills • Action 7.1. Pursue sustainability |
| • Availability of necessary resources |
• Technical Assistance (Diffusion of Innovations Theory [33]) |
• Technical Assistance: ‘Providing technical means to achieve desired behaviour.’ | Online implementation platform: To support the falls prevention team and the falls prevention coordinator, the implementation plan, along with various tools (e.g. knowledge test, meeting agenda template), will be made available online on a dedicated platform by the researchers. This enables them to collaborate within a single document, consolidates all information in one place, and facilitates easier tracking of their progress | / |
CPG Clinical practice guideline, RACF Residential aged care facility