Determinants of inter-organizational implementation success: A mixed-methods evaluation of Veteran Directed Care

dc.contributor.authorSperber, Nina R.
dc.contributor.authorMiech, Edward J.
dc.contributor.authorClary, Alecia Slade
dc.contributor.authorPerry, Kathleen
dc.contributor.authorEdwards-Orr, Merle
dc.contributor.authorRudolph, James L.
dc.contributor.authorVan Houtven, Courtney Harold
dc.contributor.authorThomas, Kali S.
dc.contributor.departmentEmergency Medicine, School of Medicine
dc.date.accessioned2024-05-31T12:19:44Z
dc.date.available2024-05-31T12:19:44Z
dc.date.issued2022
dc.description.abstractBackground: Veteran Directed Care (VDC) aims to keep Veterans at risk for nursing home placement in their communities. VA medical centers (VAMCs) purchase VDC from third-party organizational providers who then partner with them during implementation. Experiences with VDC implementation have varied. Objectives: We sought to identify conditions differentiating partnerships with higher enrollment (implementation success). Methods: We conducted a case-based study with: qualitative data on implementation determinants two and eight months after program start, directed content analysis to assign numerical scores (-2 strong barrier to +2 strong facilitator), and mathematical modeling using Coincidence Analysis (CNA) to identify key determinants of implementation success. Cases consisted of VAMCs and partnering non-VAMC organizations who started VDC during 2017 or 2018. The Consolidated Framework for Implementation Research (CFIR) guided analysis. Results: Eleven individual organizations within five partnerships constituted our sample. Two CFIR determinants- Networks & Communication and External Change Agent-uniquely and consistently identified implementation success. At an inter-organizational partnership level, Networks & Communications and External Change Agent +2 (i.e., present as strong facilitators) were both necessary and sufficient. At a within-organization level, Networks & Communication +2 was necessary but not sufficient for the non-VAMC providers, whereas External Change Agent +2 was necessary and sufficient for VAMCs. Conclusion: Networks & Communication and External Change Agent played difference-making roles in inter-organizational implementation success, which differ by type of organization and level of analysis. Implications: This multi-level approach identified crucial difference-making conditions for inter-organizational implementation success when putting a program into practice requires partnerships across multiple organizations.
dc.eprint.versionAuthor's manuscript
dc.identifier.citationSperber NR, Miech EJ, Clary AS, et al. Determinants of inter-organizational implementation success: A mixed-methods evaluation of Veteran Directed Care. Healthc (Amst). 2022;10(4):100653. doi:10.1016/j.hjdsi.2022.100653
dc.identifier.urihttps://hdl.handle.net/1805/41140
dc.language.isoen_US
dc.publisherElsevier
dc.relation.isversionof10.1016/j.hjdsi.2022.100653
dc.relation.journalHealthcare
dc.rightsPublisher Policy
dc.sourcePMC
dc.subjectLong-term care
dc.subjectImplementation science
dc.subjectMixed-methods
dc.subjectSelf-directed care
dc.subjectAging
dc.subjectLong-term services and supports
dc.subjectConfigurational analysis
dc.titleDeterminants of inter-organizational implementation success: A mixed-methods evaluation of Veteran Directed Care
dc.typeArticle
Files
Original bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
Sperber2022Determinants-AAM.pdf
Size:
107.03 KB
Format:
Adobe Portable Document Format
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
2.04 KB
Format:
Item-specific license agreed upon to submission
Description: