Table 4 Application of the RE-AIM framework to this project
RE-AIM dimension and operational definition | Plan | Indicators |
|---|---|---|
How will I and the intervention reach the targeted population? Reach is the absolute number or proportion of individuals who are willing to participate in a given initiative | •The project team has First Nations leadership with cultural advice and community engagement fostered by First Nations members of the investigator team and project staff •Relevant stakeholders at participating service organisations are all involved as project partners •Members of the project team work within the services directly with the target populations •Healthcare providers are directly reached through cultural safety training sessions, being part of a social media chat group and attending evening seminars on cultural safety, providing direct reach •We will build on the already established connections and relationships we have | •Number of health providers who participate in training, seminars, observations and interviews and who become cultural safety champions •Number of people who participate in continuous quality improvement meetings •Number of interpreters employed, and staying in employment, and who participate in training and interviews •Number of patients who participate in sharing stories about their experiences of healthcare |
How do I know my intervention is effective? Effectiveness is the impact of an intervention on outcomes, including potential negative effects, quality of life and economic outcomes | •Qualitative and quantitative outcomes will capture effectiveness of study activities in improving the following: oCultural safety, as determined by patients oPatient hospitalisation outcomes oHealthcare provider capabilities and attitude and behaviour change oWorkplace experience for interpreters and healthcare providers | •Number of patients with the following -Documentation of language -Documentation of interpreter need •Interpreter bookings -Made -Completed •% Aboriginal patients in need getting access to an interpreter •Hospitalisation outcome -Self-discharge -Unplanned readmission -Hospital length of stay -Cost •Post-training survey data (Kirkpatrick model) •Improved patient experience of care •Improved interpreter and healthcare provider workplace experience |
How do I develop organisational support to deliver my intervention? Adoption is the absolute number, proportion and representativeness of settings and intervention agents who are willing to initiate a programme | •All partner organisations have given written commitment to improving cultural safety and promoting interpreter access •Study team members will present study findings and prepare policy and practice briefs to be tabled at organisational meetings and responded to (such as the NTG Aboriginal Health Committee) •Hospitals recognise that the project helps them reach required national standards (National Safety and Quality Health Service Standards) to achieve accreditation •The National Accreditation Authority for Translators and Interpreters has a goal of certifying more Aboriginal interpreters; this project will help achieve that aim | •Engagement in investigator meetings •Uptake of study newsletter (number of people who open the electronic newsletter) •Invitations to the study team to present at partner organisation seminars, grand rounds, committee meetings •Endorsement of study outputs and uptake of policy and practice briefs provided by the study |
How do I ensure the intervention is delivered properly? Implementation refers to the intervention agents’ fidelity to the various elements of intervention’s protocol | •The project receives cultural guidance from inception through to implementation and analysis and dissemination from First Nations elders and leaders, who provide expert cultural and language advice and guidance •The project is run by an experienced team of study investigators, with a qualified project manager and research assistants •The project team is supported by research institutional structures to ensure appropriate operations (business manager, ethics committee and financial manager) •Activities, milestones and implementation issues will all be logged on an ongoing basis •Quarterly investigator meetings and continuous quality improvement meetings will provide mechanisms for keeping study implementation on track and adherent to the proposed methods •Weekly project team meetings will maintain momentum | •Activity log •Project milestone reporting to the funding agency •Annual reports to the ethics committee •The way in which intervention components may be tailored or modified during implementation will be documented in the implementation log |
How do I incorporate the intervention, so it is delivered over the long term Maintenance is the extent to which a programme or policy becomes institutionalised or part of the routine organisational practices and policies | •The use of continuous quality improvement will embed practice locally at each participating site and sustainably •The implementation model will transition training activities from being run initially by the project team to being run by the participating services during the course of the study, especially as evidence of the value of the training mounts | •Transfer of facilitation of ‘Ask the Specialist Plus’ from the study team to the health services •Transfer of health training coordination and delivery for interpreters from the study team to the health service/Aboriginal interpreter service •Evidence of actions and advocacy by Cultural Safety Champions initiated independently of the project |