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Learning Objective 1: understand how a multidisciplinary setting in Nursing Homes improved the mobility of the residents
Learning Objective 2: understand how the learning collaborative among 20 different Nursing Homes supported the implementation process
Study Design: Quality Audits and Survey
The achieved level of implementation was assessed by an audit, developed to consider the multi-professional stakeholders addressed in the guideline and to evaluate their contribution to the common outcome. Part one: the institutional level (all 20 NH), Part two: n=183 randomly chosen client cases (all 20 NH).
Additionally there were three surveys (T0/T1/T2) which addressed the staff and allow explaining the achieved audit results from an institutional (system) perspective and therefore the possibility to identify 'implementation profiles'.
Findings: The achieved degree of implementation has been higher among the persons involved within the institutions. The clients themselves, their relatives and the therapists showed a higher willingness of getting involved in the new cooperation than the physicians. Using cluster analysis we could see that in some Nursing Homes the implementation profile differs based on their way to integrate professionals who are not employees (e.g. the institutions with a better result in reference to internal/ external stakeholders show also higher dissemination levels regarding their quality management in general and the effective use of quality assuring instruments).
Conclusion:
* A multi-professional approach supports the quality improvement and outcome while implementing a evidence based guideline
* The Leadership and Quality Management Culture influence's the implementation and adaption process
* A Learning Collaborative Implementation Design supports the development of professional networks and influences their 'try-and-and-error-behavior'