Implementing four transitional care interventions for older adults: A retrospective collective case study

BACKGROUND AND OBJECTIVES: Four interventions to improve care transitions between hospital and home or community settings for older adults were implemented in Leuven, Belgium over the past four years. These complex interventions consist of multiple components that challenge their implementation in practice. This study examines the influencing factors, strategies used to address challenges in implementing these interventions, and implementation outcomes from perspectives of healthcare professionals involved.

RESEARCH DESIGN AND METHODS: This was a qualitative, collective case study which was part of the TRANS-SENIOR research network. Authors conducted semi-structured interviews with healthcare professionals about their perceptions regarding the implementation. Thematic analysis was used, and the Consolidated Framework for Implementation Research guided the final data interpretation.

RESULTS: Thirteen participants were interviewed. Participants reported major implementation bottlenecks at the organizational level (resources, structure, information continuity), while facilitators were at the individual level (personal attributes, champions). They identified the overall implementation favorably, with high uptake as a key outcome.

DISCUSSION AND IMPLICATIONS: This study highlights the strong role of healthcare providers, being motivated and self-driven, to foster the implementation of interventions in transitional care in a bottom-up way. It is important to use implementation strategies targeting both the individual-level factors as well as the organizational barriers for transitional care interventions in the future.