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 |