Proposed Topic (Most preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors (including presenting author) :
Dorothy Yingxuan Wang(1), Eliza Lai-Yi Wong(1)(2), Annie Wai-Ling Cheung(1)(2), Zoe Pui-Yee Tam(1)(2), Kam-Shing Tang(3), Eng-Kiong Yeoh(1)(2)
Affiliation :
(1) JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
(2) Centre for Health Systems & Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
(3) Kwong Wah Hospital, Hospital Authority, Hong Kong SAR, China
Introduction :
Older adult patients often face challenges in managing their medication regimens after discharge, leading to adverse events and increased healthcare utilization. Clinical information technologies have the potential to improve patient-centered care and enhance medication self-management. However, successful implementation requires addressing various individual-level factors to ensure adherence among healthcare providers.
Objectives :
This study aims to devise the most relevant, acceptable, and feasible strategies to support and enhance the implementation of a computer-based post-discharge information summary (PDIS) program to engage healthcare professionals, patients and caregivers.
Methodology :
This study employed a modified Delphi method to establish expert consensus on enhancing implementation strategies. Purposive sampling was used to recruit a diverse panel of experts, including representatives from PDIS program committees, pilot hospitals, and the Hospital Authority. The study team utilized the Behavior Change Wheel approach to systematically formulate enhancing implementation strategies. Two rounds of rating were conducted, and feedback was collected. Consensus was predefined as a threshold of 75% agreement. Experts rated the relevance, acceptability, and feasibility of each statement on a 5-point Likert scale. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed by content analysis.
Result & Outcome :
Twelve experts participated in the study, resulting in a 100% response rate. Ten out of fifteen strategy statements achieved consensus in Round 1, and the remaining 5 reached consensus in Round 2 after refinement, according to experts’ comments, established as high relevance, acceptability, and feasibility. The proposed strategies encompassed various intervention functions (e.g., education, persuasion, training, enablement, and environmental restructuring) and policy categories (e.g., service provision, communication or marketing, guidelines, and environment planning). The results indicate a strong agreement among the experts, with minimal variations across different expert groups. The main themes leading to experts’ variation included interrelations between the strategies, clinical environment constraints, relative advantages or priorities of the strategies, and engaging the appropriate stakeholders.
This study provides tailored strategies for enhancing the implementation of nurse-led PDIS for older adults and caregivers in acute care hospitals. The strategies, derived through expert consensus, address critical implementation determinants to further enhance medication self-management and patient-provider communication. The findings contribute to the existing knowledge on approaches to change healthcare providers’ behaviors and provide practical guidance for healthcare organizations seeking to improve post-discharge care for older adults.
