Table 3 Analytical framework based on the PARIHS framework [14, 15]
Codes | Explanatory Notes |
|---|---|
Evidence | |
Clinical experience and local information | Experience of individuals, teams, services that influences decision making; outlook to other service models/initiatives |
Patient experience | Patient or family engagement in service delivery or design (formal or informal) |
Research | Research evidence (e.g. papers, guidelines, conferences), data sources or processes (e.g. local or state-wide databases, audits), evaluation of service delivery |
Recipients | |
Capability | Knowledge, skills, memory, attention and decision processes, behavioural regulation |
Motivation | Social/professional role and identity, values, beliefs about capabilities, optimism, beliefs about consequences, intentions, goals, reinforcement, emotion |
Inner Context (ward and organisation) | |
Adequate resourcesa | Time, personnel, equipment, education materials |
Culture | Specific to care of older people and factors influencing this (e.g. teamwork, interdisciplinary care, innovation), ward/service line/organisation level |
Experience with change | Past implementation/change experiences: positive/ negative, factors associated with success/ failure |
Leadership | Formal and informal leaders, ward/service line/executive, across disciplines |
Organisational priorities | Specific to care of older people and factors influencing this (e.g. teamwork, interdisciplinary care, innovation) |
Structure | Hospital organisational structure (reporting, governance, service lines), physical structure (physical space, layout of wards/hospital), structure of university courses and curriculum, |
Systems and processes | Models of care, processes for screening, referral, discharge planning, communication processes, |
Outer context (health service district, state, national) | |
Environmental (in)stability | Change in political or social environment which may affect older people and/or health care |
Incentives and mandates | External funding, restrictions, |
Policy drivers, priorities | Broad political agenda relating to older people and/or health care |
Inter-organisational networks and relationships | Networks and relationships with community (aged care, GPs, community service providers), universities, other health care organisations |
Regulatory frameworks | Health care (i.e. accreditation standards) and university (i.e. competency standards for new graduates) |
Society values and expectationsa | Society perceptions related older people and/or health care |