ArticleBMC health services research2026
Barriers and facilitators to implementing discharge preparation services for older adults with multimorbidity: a qualitative study guided by the updated CFIR.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo explore barriers and facilitators to implementing a discharge preparation service program for older adults with multimorbidity, and to inform improvements in this service.
methodsUsing purposive sampling, we recruited 4 physicians, 14 nurses, 6 patients, and 6 caregivers for semi-structured interviews. The Consolidated Framework for Implementation Research (CFIR) guided the development of the interview guide and analysis. Inductive-deductive analyses were conducted.
resultsThe findings encompassed 20 constructs across the four CFIR domains (Innovation, Outer Setting, Inner Setting, and Individuals), identifying 11 facilitators, 14 barriers, and 2 neutral factors. Key implementation facilitators included a reliable evidence base, favorable environmental conditions and resources, multidisciplinary team establishment, and leadership support. Primary barriers comprised intervention complexity, increased labor costs, incomplete policies and models, lack of financial incentives, and poor compliance.
conclusionIn summary, this study comprehensively analyzed the potential influencing factors for implementing discharge preparation services for older adults with multimorbidity. Providing discharge preparation services for this population requires not only a solid evidence base, but also appropriate staffing, convenient and standardized workflows, enhanced training for service providers, and supportive policy and referral infrastructure. These findings advance our understanding of the multilevel conditions necessary for successful implementation of discharge preparation services in this population.
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