ArticleThe health care manager
Barriers and Facilitators to Implementing a Change Initiative in Long-Term Care Using the INTERACT® Quality Improvement Program.
Article in The health care manager. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Transitional Care Interventions for Older Residents of Long-term Care Facilities: A Systematic Review and Meta-analysis.JAMA network open · 2022Pooled it
- Trial
- Sustainable improvement of interprofessional care for better resident outcomes: protocol for the INTERSCALE hybrid type III effectiveness cluster-randomized trial comparing individualized and collaborative delivery of an evidence-based care model for long-term care.Implementation science : IS · 2026Trial
- Nursing home performance in a trial to reduce hospitalizations: Implications for future trials.Journal of the American Geriatrics Society · 2021Trial
- Trial
- The Implementation of Dementia Care Mapping in a Randomized Controlled Trial in Long-Term Care: Results of a Process Evaluation.American journal of Alzheimer's disease and other dementias · 2019Trial
- Degree of Implementation of the Interventions to Reduce Acute Care Transfers (INTERACT) Quality Improvement Program Associated with Number of Hospitalizations.Journal of the American Geriatrics Society · 2018Trial
- Trial
- Effects of an Intervention to Reduce Hospitalizations From Nursing Homes: A Randomized Implementation Trial of the INTERACT Program.JAMA internal medicine · 2017Trial
- Three Case-Based Approaches to Preimplementation Evaluation in Nursing Homes: Understanding Enablers, Barriers, and Implementation Strategies.Journal of the American Medical Directors Association · 2026Article
- Enabling Fresh-Produce Availability in Long-Term Care via Hydroponic Green Walls: A Multisite Operational and Cost Evaluation.Nutrients · 2026Observational
- Acute Deterioration in Long-Term Care: A Delphi Study of Indicators, Care Pathways and Implementation Strategies.International journal of nursing practice · 2026Article
- Exploring Barriers and Facilitators to Incorporating New Practices and Innovations in the Pediatric Perioperative Ecosystem in Sub-Saharan Africa: A Mixed Methods Study.Paediatric anaesthesia · 2026Article
- Healthcare Utilization Disparities Among Older Adults With and Without Cognitive Impairment: Health and Retirement Study Findings.Journal of cross-cultural gerontology · 2026Article
- Understanding the development and implementation of national quality of care and patient safety strategic documents: a scoping review.BMC health services research · 2025Article
- Improving staff awareness of sensory aid needs and dementia status in an old age ward.BMJ open quality · 2025Article
- Article
- Healthcare Disparities Among Older Adults: Exploring Social Determinants of Health and Cognition Levels.medRxiv : the preprint server for health sciences · 2024Article
- Pilot study to evaluate the need and implementation of a multifaceted nurse-led antimicrobial stewardship intervention in residential aged care.JAC-antimicrobial resistance · 2024Article
- Developing a Data and Analytics Platform to Enable a Breast Cancer Learning Health System at a Regional Cancer Center.JCO clinical cancer informatics · 2023Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
Implementation of major organizational change initiatives presents a challenge for long-term care leadership. Implementation of the INTERACT® (Interventions to Reduce Acute Care Transfers) quality improvement program, designed to improve the management of acute changes in condition and reduce unnecessary emergency department visits and hospitalizations of nursing home residents, serves as an example to illustrate the facilitators and barriers to major change in long-term care. As part of a larger study of the impact of INTERACT® on rates of emergency department visits and hospitalizations, staff of 71 nursing homes were called monthly to follow-up on their progress and discuss successful facilitating strategies and any challenges and barriers they encountered during the yearlong implementation period. Themes related to barriers and facilitators were identified. Six major barriers to implementation were identified: the magnitude and complexity of the change (35%), instability of facility leadership (27%), competing demands (40%), stakeholder resistance (49%), scarce resources (86%), and technical problems (31%). Six facilitating strategies were also reported: organization-wide involvement (68%), leadership support (41%), use of administrative authority (14%), adequate training (66%), persistence and oversight on the part of the champion (73%), and unfolding positive results (14%). Successful introduction of a complex change such as the INTERACT® quality improvement program in a long-term care facility requires attention to the facilitators and barriers identified in this report from those at the frontline.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.