Translating research into clinical practice: making change happen.
OBJECTIVE
To describe the process of adoption of an evidence-based, multifaceted, innovative program into the hospital setting, with particular attention to issues that promoted or impeded its implementation. This study examined common challenges faced by hospitals implementing the Hospital Elder Life Program (HELP) and strategies used to address these challenges.


METHODS
Qualitative study design based on in-depth, open-ended telephone interviews.


METHODS
Nine hospitals implementing HELP throughout the United States.


METHODS
Thirty-two key staff members (physician, nursing, volunteer, and administrative staff) who were directly involved with the HELP implementation.


METHODS
Staff experiences implementing the program, including challenges and strategies they viewed as successful in overcoming challenges of implementation.


RESULTS
Six common challenges faced hospital staff: (1) gaining internal support for the program despite differing requirements and goals of administration and clinical staff, (2) ensuring effective clinician leadership, (3) integrating with existing geriatric programs, (4) balancing program fidelity with hospital-specific circumstances, (5) documenting positive outcomes of the program despite limited resources for data collection and analysis, and (6) maintaining the momentum of implementation in the face of unrealistic time frames and limited resources. Strategies perceived to be successful in addressing each challenge are described.


CONCLUSIONS
Translating research into clinical practice is challenging for staff across disciplines. Developing strategies to address common challenges identified in this study may facilitate the adoption of innovative programs within healthcare organizations.
Bradley
Elizabeth H
EH
Department of Epidemiology and Public Health, Yale School of Medicine, 60 College Street, New Haven, CT 06520, USA. elizabeth.bradley@yale.edu
Schlesinger
Mark
M
Webster
Tashonna R
TR
Baker
Dorothy
D
Inouye
Sharon K
SK
D000368:Aged; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine; D006302:Health Services Research; D006299:Health Services for the Aged / Q000458:organization & administration*; D006801:Humans; D007407:Interviews as Topic; D009936:Organizational Innovation; D009937:Organizational Objectives; D016730:Program Development; D015397:Program Evaluation; D011785:Quality Assurance, Health Care; D014481:United States; D000078329:Workforce