Table 1 Implementation strategy
Behavioral change techniques [26] | Mode of delivery (how) | Content (what materials, what procedure) | Provider (who provided) | Setting (where) | Recipient (to whom) | Intensity (when and how much) over how many contacts) | Duration (over what period of time) |
|---|---|---|---|---|---|---|---|
Prompts/cues (introduce stimulus with the purpose of prompting or cueing the behavior) | Flags in the clinical pathway | Key reminders will be prompted (i.e., anticipated discharge date on or before day 6) | Manager and/or the physician assistant | Ortho and off service units | Nurses, occupational therapists, physiotherapist, social workers, physicians, residents, administrators | Ongoing | Ongoing |
Standardized transfer of information (to include all essential patient information) | Key information needed for referral will be sent to geriatric rehabilitation | Admission coordinator | Ortho and off service units | Nurses, occupational therapists, physiotherapist, social workers, physicians, residents, administrators | Ongoing | Ongoing | |
High-risk delirium screening | Identify high risk patients for delirium | Manager and/or the physician assistant | Ortho and off service units | Nurses, occupational therapists, physiotherapists, social workers, physicians, residents, administrators | Ongoing | Ongoing | |
Feedback on behavior (monitor and provide feedback on the outcome of performance of the behavior) | Dashboard to provide immediate feedback to clinicians | Provide data to all team members (for example: # of hip fractures, % referred to geriatric rehabilitation, etc.) | Research assistant | Ortho, off service units and geriatric rehabilitation | Nurses, occupational therapists, physiotherapist, social workers, physicians, residents, administrators | Weekly | Ongoing |
Social and environmental consequences (provide information (e.g., written, verbal, visual) about social and environmental consequences of performing the behavior) | Multidisciplinary workshops a | PATH4HIP training Provide evidence to staff about the advantages of discharging patients earlier | Educators | Ortho, off service units and geriatric rehabilitation | Nurses, occupational therapists, physiotherapist, social workers, physicians, residents, administrators | Workshops | 60 min |
Reminders a (i.e., posters, daily rounds) | Provide visual, verbal and written reminders to all team members | Local champions | Ortho, off service units and geriatric rehabilitation | Nurses, occupational therapists, physiotherapist, social workers, physicians, residents, administrators | Ongoing | 5–10 min | |
Sustained participant and site engagement a (including site visits, emails to all staff and physicians) | Discuss progress, and improvement opportunities | Local champions | Ortho, off service units and geriatric rehabilitation | Nurses, occupational therapists, physiotherapist, social workers, physicians, residents, administrators | Regular follow-ups with all participants at all sites | 15–30 min | |
Patient information 1) Paper booklet 2) Information on organizations’ website 3) Video | Educate patients about benefits of going to geriatric rehabilitation, what to expect, etc. | Educators | Ortho, off service units and geriatric rehabilitation | Patients and families | Ongoing | 5–10 min |