Undertaking a Collaborative Rapid Realist Review to Investigate What Works in the Successful Implementation of a Frail Older Person’s Pathway

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Title: Undertaking a Collaborative Rapid Realist Review to Investigate What Works in the Successful Implementation of a Frail Older Person’s Pathway
Authors: Ní Shé, Éidín
Keogan, Fiona
McAuliffe, Eilish
Cooney, Marie Therese
et al.
Permanent link: http://hdl.handle.net/10197/9214
Date: 25-Jan-2018
Abstract: We addressed the research question “what factors enable the successful development and implementation of a frail older person’s pathway within the acute setting”. A rapid realist review (RRR) was conducted by adopting the RAMESES standards. We began with a sample of 232 articles via database searches supplemented with 94 additional records including inputs from a twitter chat and a hospital site visit. Our final sample consisted of 18 documents. Following review and consensus by an expert panel we identified a conceptual model of context-mechanism-(resources)-outcomes. There was overall agreement frailty should be identified at the front door of the acute hospital. Significant challenges identified related to organisational boundaries both within the acute setting and externally, the need to shift outcomes to patient orientated ones, to support staff to sustain the pathway by providing ongoing education and by providing role clarity. RRRs can support research such as the systematic approach to improving care for frail older adults (SAFE) study by producing accounts of what works based on a wide range of sources and innovative engagement with stakeholders. It is evident from our provisional model that numerous factors need to combine and interact to enable and sustain a successful frail older person’s pathway.
Funding Details: Health Research Board
Type of material: Journal Article
Publisher: MDPI
Copyright (published version): 2018 the Authors
Keywords: Frailty;Older people;Pathways;Acute;Realist review;Co-design;Implementation;Stakeholder engagement
DOI: 10.3390/ijerph15020199
Language: en
Status of Item: Peer reviewed
Appears in Collections:Nursing, Midwifery & Health Systems Research Collection
Medicine Research Collection

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