6th UK Implementation Science Research Conference
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PRESENter
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Biography
Tracey Brighton is an Allied Health Professional with over 22 years of experience working in the healthcare industry as both a clinician and a healthcare leader. Possessing a clinical background in Physiotherapy, she has worked in both the public and private sectors and has held leadership positions in the public health system for the past 12 years. Tracey has extensive experience in strategic leadership and planning, workforce redesign and development, project and change management and service development.
To complement her a Bachelor of Physiotherapy and a Graduate Diploma in Health Management, Tracey has recently completed a Diploma of Professional Coaching.
background
Discover disinvestments, Adapt or abandon, Reinvest or recoup, and Evaluate and embed; introducing the DARE Framework to deliver higher value healthcare
More than 80 implementation theories, models and frameworks support implementation of health service innovations and translating knowledge to practice; growing attention is directed towards deimplementation approaches. However, a pragmatic, integrated model or framework that supports pragmatic deimplementation to reinvest approaches remains lacking.
This initiative aimed to co-design a framework and toolkit to support de-implementation to reinvest healthcare improvements
MEthod
The knowledge-to-action framework underpinned development of the DARE Framework and toolkit for feasibility testing in a convenience sample of allied health services in a single metropolitan hospital.
results
An initial conceptual framework synthesised concepts from underlying theories (n=3), process models(n=5), determinant(n=5) and evaluation frameworks (n=3) in August 2021. Iterative co-design with stakeholders between August 2021 and October 2021 applied data from twenty-four nominal group technique workshops, and 3 semi-structured small group interviews. Findings were triangulated using informal focus groups, interviews and meetings to co-engage stakeholders in the iterative development, implementation, and refinement of the model and draft toolkit. Full consensus for facilitated rapid action cycle implementation and pragmatic feasibility testing of the draft model across allied health services for a 700+ bed hospital was then achieved in November 2021 in response to COVID driven budgetary and care needs. At time of abstract preparation, RE-AIM evaluation demonstrates ongoing iterative adaptation of the model and toolkit, willingness for update and spread to medical and nursing professions, adoption, implementation and embedment of ranked deimplementation and reinvestment opportunities across all core allied health services in the test site. Limited effectiveness testing to date across process measures and quadruple aim healthcare outcomes appears strongly favourable; detailed findings will presented at conference as a qualitative case series.
Conclusion
Early data supports consideration of the DARE Framework as a useful approach to support rapid cycle, deimplement to reinvest approaches to facilitate values-based health care.