title: Integrating the transitional relationship model into clinical practice.
abstract: BACKGROUND
  The challenge of facilitating knowledge translation in clinical practice includes enabling practitioners and agencies to implement a common set of best practices, such as the Transitional Relationship Model (TRM). In 1992, a participatory action project implemented the TRM on a long-term psychiatric hospital ward in Ontario, Canada. All participants were successfully "bridged" to the community. Despite positive outcomes associated with the TRM, implementation of any best practice is difficult because it involves changing processes.
  
  
  OBJECTIVE
  It was hypothesized that using multiple implementation strategies developed by wards that had already implemented the model would result in improved TRM implementation.
  
  
  METHODS
  This study compared three groups of hospital wards; Group A wards had already adopted the TRM, Group B wards implemented the TRM in Year 1, and Group C wards implemented the TRM in Year 2. An iterative process was used in which strategies suggested by the A wards were used to enhance implementation on the B and C wards, respectively. These included enhancing staff participation, creating/maintaining supportive ward milieus, meeting specific educational needs, and supporting managers throughout the implementation process. The degree of actual implementation on each ward served as the primary outcome measure.
  
  
  RESULTS
  Group C implemented the TRM model significantly quicker than the other groups. Sustainability in the initial A wards required the implementation of additional strategies used by the later wards.
authors.affiliation: Arthur Labatt Family School of Nursing, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada. cforchuk@uwo.ca
authors.forename: Cheryl
authors.initials: C
authors.lastname: Forchuk
authors.forename: Mary-Lou
authors.initials: ML
authors.lastname: Martin
authors.forename: Elsabeth
authors.initials: E
authors.lastname: Jensen
authors.forename: Susan
authors.initials: S
authors.lastname: Ouseley
authors.forename: Patricia
authors.initials: P
authors.lastname: Sealy
authors.forename: Georgiana
authors.initials: G
authors.lastname: Beal
authors.forename: William
authors.initials: W
authors.lastname: Reynolds
authors.forename: Siobhan
authors.initials: S
authors.lastname: Sharkey
mesh_terms: D000704:Analysis of Variance; D003156:Community Mental Health Services / Q000379:methods; D006284:Health Plan Implementation / Q000379:methods*; D006778:Hospitals, Psychiatric / Q000458:organization & administration*; D006801:Humans; D016014:Linear Models; D016294:Models, Nursing; D009723:Nurse-Patient Relations; D009864:Ontario; D010351:Patient Discharge; D017410:Practice Guidelines as Topic; D057170:Translational Research, Biomedical / Q000379:methods*