What | Why | Who | Target behaviour | How, when and how often | Tailoring | Modifications | ||
---|---|---|---|---|---|---|---|---|
Component | Rationale | Delivered by | Delivered to | Mode and frequency | Planned adaptation | During the study | ||
Organisational level | 1. Implementation steering group led by clinical project manager | To ensure ‘successful planning, execution, monitoring, controlling and closing of the project’ (document). Project manager ‘problem solving’ (I) | Project Manager, coordinator, representative from hospital, community, management | Heads of disciplines, management, MDTs, referrers | Multiple behaviours: ‘supporting implementation of fall risk assessment clinics’ | Face to face monthly meetings, ongoing email and telephone contact | ‘Communication tailored to the requirements of different audiences’ (D) | |
2. Appointed coordinator and administrator | To create ‘single point of contact’ for referrers, MDTs and clients. Previous efforts failed due to lack of ‘practical support’ (I) | NA | MDTs, referrers, heads of discipline, management | Multiple behaviours: ‘supporting implementation of fall risk assessment clinics’ | Ongoing meetings, phone and email contact with MDTs and referrers | Mode of communication ‘depends on the person’ in each clinic (I) | ||
3. Set up MDT to deliver assessment | Identify and assemble team of physiotherapist, occupational therapist, nurse | Coordinator Project manager | 1. Head of discipline 2. Line managers | Multiple behaviours: ‘supporting implementation of fall risk assessment clinics’ | Face to face meetings and phone contact prior to initiating clinic | No reference | ||
Professional: multidisciplinary team | 4. Training and ‘coaching’ | To provide ‘coaching and mentoring to MDTs’ in conducting assessment to ensure team were ‘comfortable’. (I) | Coordinator Administrator Specialist fall team | MDT | Delivering risk assessment clinic | Face to face Prior to initiation and during weeks 2–3 of implementation | No reference | Number, timing and duration varied based on knowledge, requests and availability |
5. Standard assessment form | Enable standardised assessment and onward referral | Coordinator Administrator | MDT | Delivering risk assessment clinic | Circulated prior to initiating clinic | No reference | Format and level of information changed during pilot | |
6. Equipment | To ensure assessment could be conducted | Coordinator Administrator | MDT | Delivering risk assessment clinic | Prior to initiating clinic | Dependent on existing equipment | ||
Professional: referrers | 7. Standard referral form | Enable efficient referral to service | Coordinator | Referrers | Refer to clinic | Circulated during initial implement | No reference | Level of information changed during pilot |
8. Information meetings with referrers | ‘Selling’ clinics to get referrers ‘on board’ and ‘to discuss criteria on who we want (referred) and [ensure] that is very clear’.(I) | Coordinator Specialists Project manager | Physicians ANPs PHNs | Refer to clinic | Ad-hoc face to face meetings ‘ideally’ before clinic started (I) | Timing depended on clinic being established in that area | Number of meetings increased in areas with low referral rates | |
9. Screening tool for PHNs | Generate referrals for the clinics among PHNs who ‘would be the first line of contact with the health service.’ (I) | Coordinator Director of Public Health Nursing | PHNs | Identify eligible clients and refer to clinic | Ad-hoc face to face meetings to introduce and promote use of tool | No reference | Number and timing of meetings varied by area and level of engagement | |
10. Promotional material | Advertise and inform referrers about clinics | Coordinator Administrator | Referrers Pharmacies, Day centres | Refer to clinic | Flyers, posters, monthly mail shot (to GPs) | No reference | ||
Patient | 11. Invitation letter and information leaflet | To inform clients about appointment, clinic location and how to prepare for their visit, centralising administration to support MDTs. | Coordinator Administrator | Clients | Attend clinic | Documents provided on receipt of referral and arrangement of appointment | No reference |