ArticleThe Gerontologist2020
Identifying the Implementation Conditions Associated With Positive Outcomes in a Successful Nursing Facility Demonstration Project.
Article in The Gerontologist, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses 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
30 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- How Have Quality Improvement Strategies Been Adopted and How Has Impact Been Assessed in Care Homes for Older People? A Systematic Search and Narrative Review.International journal of older people nursing · 2025Pooled it
- Nurses Training and Capacitation for Palliative Care in Emergency Units: A Systematic Review.Medicina (Kaunas, Lithuania) · 2020Pooled it
- Difference-Makers for Robust Implementation of a Nursing Home Advance Care Planning Embedded Pragmatic Clinical Trial.Journal of the American Geriatrics Society · 2026Trial
- Defining optimal implementation packages for delivering community-wide mass drug administration for soil-transmitted helminths with high coverage.BMC health services research · 2022Trial
- Community organization capacity and barriers to mental health promotion efforts: a configurational analysis.BMC public health · 2026Article
- How segregation, low birth weight, unemployment, and violence link to low life expectancy in Chicago.Health affairs scholar · 2026Article
- Coincidence analysis: Identifying factors contributing to frontline health workers' confidence to face future pandemics across Honduras, Syria, and South Sudan.PLOS global public health · 2026Article
- Difference-Making Factors Linked to Higher Reach of Specialist Palliative Care Among People With Heart Failure Across a National Sample of VA Medical Centers.The American journal of hospice & palliative care · 2025Article
- Use of Hospice and End-of-Life Care Quality Among Medical Centers with High Versus Lower Specialist Palliative Care Reach Among People with Heart Failure: An Observational Study.Journal of palliative medicine · 2024Observational
- Difference-Making Pathways to Frailty Through Social Factors: A Configurational Analysis.The Gerontologist · 2024Article
- Coming back for more: factors linked to higher participation among Veterans with chronic pain in an innovative VA-YMCA wellness clinic.BMJ open quality · 2024Article
- Article
- The role of organizational capacity in intervention efficacy in a church-based cancer education program: A configurational analysis.Global implementation research and applications · 2023Article
- Using qualitative comparative analysis to understand the conditions that produce successful PrEP implementation in family planning clinics.Implementation science communications · 2023Article
- The VA National TeleNeurology Program implementation: a mixed-methods evaluation guided by RE-AIM framework.Frontiers in health services · 2023Article
- Modeling Contingency in Veteran Community Reintegration: A Mixed Methods Approach.Journal of mixed methods research · 2023Article
- Determinants of inter-organizational implementation success: A mixed-methods evaluation of Veteran Directed Care.Healthcare (Amsterdam, Netherlands) · 2022Article
- Protocol for evaluating external facilitation as a strategy to nationally implement a novel stigma reduction training tool for healthcare providers.Implementation science communications · 2022Article
- Coincidence Analysis: A Novel Approach to Modeling Nurses' Workplace Experience.Applied clinical informatics · 2022Article
- Observational
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesTo identify the implementation barriers, facilitators, and conditions associated with successful outcomes from a clinical demonstration project to reduce potentially avoidable hospitalizations of long-stay nursing facility residents in 19 Indiana nursing homes. RESEARCH DESIGN AND
methodsOptimizing Patient Transfers, Impacting Medical quality, Improving Symptoms-Transforming Institutional Care (OPTIMISTIC) is a multicomponent intervention that includes enhanced geriatric care, transition support, and palliative care. The configurational analysis was used to analyze descriptive and quantitative data collected during the project. The primary outcome was reductions in hospitalizations per 1,000 eligible resident days.
resultsAnalysis of barriers, facilitators, and conditions for success yielded a model with 2 solution pathways associated with a 10% reduction in potentially avoidable hospitalizations per 1,000 resident days: (a) lower baseline hospitalization rates and investment of senior management; or (b) turnover by the director of nursing during the observation period. Conditions for success were similar for a 20% reduction, with the addition of increased resident acuity. DISCUSSION AND IMPLICATIONS: Key conditions for successful implementation of the OPTIMISTIC intervention include strong investment by senior leadership and an environment in which baseline hospitalization rates leave ample room for improvement. Turnover in the position of director of nursing also linked to successful implementation; this switch in leadership may represent an opportunity for culture change by bringing in new perspectives and viewpoints. These findings help define the conditions for the successful implementation of the OPTIMISTIC model and have implications for the successful implementation of interventions in the nursing facility more generally.
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Registered trials
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