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Table 2 Process outcomes, constructs and methods of data collection

From: Implementing the chronic care model for frail older adults in the Netherlands: study protocol of ACT (frail older adults: care in transition)

Outcome Concept Methods
Level of implementation Fidelity ·Semi-structured interviews* with geriatric team members, nurses, primary care physicians
·Focus groups* with practice nurses
·Tailored care plans, time registration by practice nurses, registrations by expert geriatric teams, minutes of team meetings and training sessions
Dose delivered (completeness) ·Tailored care plans
Total number of care plans delivered to clients during the intervention
·Tailored care plans (sample)
Average number of observations (RAI outcomes, nurses’ own observations) per care plan
Average number of actions formulated per care plan
Average number of care professionals involved in actions listed
·Time registrations by practice nurses
Average amount of nurse’s working hours spent delivering intervention components (e.g. In-home assessments and care plan evaluation with clients, consultations with primary care physician, multidisciplinary consultations)
·Registrations by expert geriatric teams
Number of multidisciplinary consultations organized
Dose received (exposure, satisfaction) ·Minutes of team meetings, registrations by expert geriatric teams
Number of training and coaching sessions and frequency of nurse’s attendance at these sessions
Number of team meetings and frequency of nurse’s attendance at these meetings
·Semi-structured interviews* with geriatric team members, nurses, primary care physicians
·Focus groups* with practice nurses, local stakeholders
Barriers and facilitators to implementation Barriers on cultural, operational and structural levels ·Semi-structured interviews* with older adults, geriatric team members, nurses, primary care physicians
·Focus groups * with practice nurses, stakeholders
Extent to which transition is achieved Client autonomy ·Semi-structured interviews * with older adults
·CCCQ questionnaire **
Coordination of care from the perspective of health professionals and patients ·Semi-structured interviews * with geriatric team members, nurses, primary care physicians, older adults
·Focus groups * with practice nurses
·2 Items on QUOTE questionnaire **
Learning experiences of professionals Timely identification of health problems and care needs ·Tailored care plans
Percentage of total number of RAI outcomes and nurses’ own registrations previously unknown to heath care professionals
  ·Semi-structured interviews * with geriatric team members, nurses, primary care physicians
·Focus groups * with practice nurses, stakeholders
  1. * The qualitative study sample will include all older adults and health care professionals participating in the project, i.e. practice nurses, geriatric team members and primary care physicians and will be selected by means of a purposive (maximum variation) sampling procedure [48]; ** The quantitative study sample will include all older adults participating in the study; CCCQ Client-centred Care Questionnaire; QUOTE QUality Of care Through the patient’s Eyes.