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Table 1 Context of clinical settings for CONNECT interventions

From: Adapting to CONNECT: modifying a nursing home-based team-building intervention to improve hospital care team interactions, functioning, and implementation readiness

Intervention Context

CONNECT for Quality

CONNECT for STRIDE

Clinical Setting

Nursing Home

Hospital Inpatient General Medicine Ward

Clinical Program Tasks

Existing task: Falls prevention

New task: Supervised walking

Team Formation and Processesa

Existing team formation/structure

New team processes

Existing team formation/structure

New team processes

Boundary spanningb

No

Yes

Team Membership: Roles in program delivery

Registered Nurse, Licensed Practice Nurse: fall risk factor assessment and intervention focusing on orthostatics, gait, toileting, medications, environmental hazards

Nursing Assistant: fall risk factor identification and intervention focusing on gait, footwear, toileting, hip protectors, and environmental hazards

MD/NP/PA prescriber and Pharmacist: risk factor assessment, risk factor reduction focusing on psychotropic medication reduction and Vitamin D

Non-clinical Staff (e.g., dining, environmental services, activities): identify environmental hazards, communicate changes in resident status

Physician (General Medicine): referral

Registered Nurse: coordinate patient/visit schedules

Physical Therapist: initial evaluation, oversight for walking assistant

Licensed Practice Nurse, Certified Nursing Assistant, Physical Therapist Assistant: supervising walks

• Unplanned, hospital-led and site-specific additions to STRIDE teams:

Speech pathologists

Kinesiology technician

Safe patient handling and mobility coordinator

• Program managers (Registered Nurse, Physical Therapy)

Communication challenges in program delivery

• Insufficient connections (e.g., quality of interactions) between nursing home staff across roles

• Communicating relevant clinical information

• Limited use of diverse perspectives and interdependent interaction for problem solving

• Clarity of roles

• Communicating relevant clinical information and “prescribed dose” of STRIDE

  1. aTeam formation describe whether new care teams or structures were formed for new clinical program delivery. Team processes describe whether healthcare teams developed new processes (e.g., operational, clinical) for delivering care
  2. bBoundary spanning refers to the extent to which tasks and interactions (e.g., care delivery, evaluation, coordination) involve interdependencies with external groups or expertise (e.g., clinical specialty, professional roles) in order to meet clinical program objectives