Determinants of inter-organizational implementation success: A mixed-methods evaluation of Veteran Directed Care
dc.contributor.author | Sperber, Nina R. | |
dc.contributor.author | Miech, Edward J. | |
dc.contributor.author | Clary, Alecia Slade | |
dc.contributor.author | Perry, Kathleen | |
dc.contributor.author | Edwards-Orr, Merle | |
dc.contributor.author | Rudolph, James L. | |
dc.contributor.author | Van Houtven, Courtney Harold | |
dc.contributor.author | Thomas, Kali S. | |
dc.contributor.department | Emergency Medicine, School of Medicine | |
dc.date.accessioned | 2024-05-31T12:19:44Z | |
dc.date.available | 2024-05-31T12:19:44Z | |
dc.date.issued | 2022 | |
dc.description.abstract | Background: 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.version | Author's manuscript | |
dc.identifier.citation | Sperber 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.uri | https://hdl.handle.net/1805/41140 | |
dc.language.iso | en_US | |
dc.publisher | Elsevier | |
dc.relation.isversionof | 10.1016/j.hjdsi.2022.100653 | |
dc.relation.journal | Healthcare | |
dc.rights | Publisher Policy | |
dc.source | PMC | |
dc.subject | Long-term care | |
dc.subject | Implementation science | |
dc.subject | Mixed-methods | |
dc.subject | Self-directed care | |
dc.subject | Aging | |
dc.subject | Long-term services and supports | |
dc.subject | Configurational analysis | |
dc.title | Determinants of inter-organizational implementation success: A mixed-methods evaluation of Veteran Directed Care | |
dc.type | Article |