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Table 2 Overview of outcome domains and subdomains of the quantitative process evaluation

From: Implementation, mechanisms of change and contextual factors of a complex intervention to improve interprofessional collaboration and the quality of medical care for nursing home residents: study protocol of the process evaluation of the interprof ACT intervention package

Domains

Subdomains

Dimensions

Target population and measurement points

Measurement instruments (existing tools useda)

IPAVs

RNs

NHDs

NHRs

GPs

STM

Implementation strategies and activities

 Implementation strategies

Kick-off meeting

Attitudes, quality, and satisfaction

(T0b)

(T0b)

(T0b)

(T0b)

(T0b)

(T0b)

Questionnaires, minutes

IPAV characteristics

E.g., roles and self-efficacy

T0b

T0b

Questionnaires, minutes

IPAV training

Duration, adaptations, quality, and satisfaction

T0b

T0b

Questionnaires, minutes

IPAV supervision

Quality and satisfaction

T0b

T0b

Questionnaires, minutes

 IPAV work

Collaboration IPAV and IPAV substitutes

Quality and satisfaction

T1, T2

Questionnaires

IPAV activities, e.g., in-house training courses and discussions with target groups

Current practice

T1, T2

T1, T2

Questionnaires

 Implementational work within team (normalization process theory)

Coherence, cognitive participation, collective action, reflexive monitoring

T1, T2

T2

Questionnaires (NoMAD questionnaire)

interprof ACT intervention package

 Intervention package as a whole

Dose and reach

T1, T2

Questionnaires (NoMAD questionnaire), minutes

 Name badges

 

Choice and adaptation, dose and reach, local policies, current practice

T1, T2

T0a, T2

T0a, T2

T0a, T2

T1, T2

CRF, questionnaire, minutes

 Mandatory availability rules

Choice and adaptation, dose and reach, attitudes, current practice, quality, and satisfaction

T1, T2

T0a, T2

T0a, T2

T0a, T2

T1, T2

CRF, questionnaire, minutes (Koverdem, InDemA)

 Designated contact persons

 

Choice and adaptation, dose and reach, attitudes, local policies, current practice, quality and satisfaction

T1, T2

T0a, T2

T0a, T2

T0a, T2

T1, T2

CRF, questionnaire, minutes (InDemA)

 Standardized home visits

 

Choice and adaptation, dose and reach, attitudes, current practice, quality, and satisfaction

T1, T2

T0a, T2

T0a, T2

T0a, T2

T0a, T2

T1, T2

CRF, questionnaire, minutes (InDemA)

 Pro re nata medication

 

Choice and adaptation, dose and reach, current practice, quality and satisfaction

T1, T2

T0a, T2

T0a, T2

T0a, T2

T1, T2

CRF, questionnaires, minutes

 Shared goal setting

 

Choice and adaptation, dose and reach, attitudes, current practice, quality, and satisfaction

T1, T2

T0a, T2

T0a, T2

T0a, T2

T1, T2

CRF, questionnaire, minutes (InDemA, Koverdem, PSAT)

Key elements of interprofessional collaboration

 Interprofessional communication

 

Attitudes, current practice, quality, and satisfaction

T1, T2

T0a, T2

T0a, T2

T0a, T2

CRF, questionnaires (CPAT, Koverdem)

 Involvement of NHR

 

Current practice, quality, and satisfaction

T2

T0a, T2

T0a, T2

T0a, T2

T0a, T2

CRF, questionnaires (ZAP)

 Contribution of involved professions

 

Attitudes, current practice, quality, and satisfaction

T1, T2

T0a, T2

T0a, T2

Questionnaires (CPAT, InDemA, Jefferson Scale, PSAT)

 Coordination of care decision and care planning

 

Attitudes, current practice

T0a, T2

T0a, T2

T0a, T2

CRF, questionnaires (InDemA)

Further domains related to interprofessional collaboration and medical care

 General interprofessional collaboration

 

Attitudes, quality and satisfaction, time resources

T1, T2

T0a, T2

T0a, T2

T0a, T2

CRF, questionnaires (InDemA, Koverdem)

 General (medical) care for NHR

 

Quality and satisfaction utilization of emergency or hospital services (self-reported changes), adverse outcomes

T2

T2

T2

T0a, T2

T2

CRF, questionnaires (ZAP, EUROPEP)

 Further outcomes

 

Staff outcome, marketing outcome

T0a, T2

CRF

Contextual factors

 Meso: organizational level

Time resources

 

T1, T2

Minutes

Leadership and work environment

 

T1, T2

T2

T0a, T2

Questionnaires (PES Nursing Work Index, NoMAD), minutes

Financial and staff resources

 

T1, T2

T0a, T2

T0a, T2

T0a, T2

CRF, questionnaires, minutes

Structures of collaboration and medical care

Attitudes, current practice, quality, and satisfaction

T1, T2

T0a, T2

T0a, T2

T0a, T2

Questionnaires (InDemA adapted)

GP office and NH characteristics

 

T0a, T2

T0a, T2

CRF, questionnaires (Koverdem), minutes

 Micro: staff level

Sociodemographic characteristics of all persons involved in implementation

 

T0b

T0a, (T0b), T2

T0a, (T0b), T2

T0a, (T0b)

Questionnaires, minutes

Expected effects of high quality RN-GP collaboration

 

T0a, T2

T0a, T2

T0a, T2

CRF, questionnaires (Koverdem)

Competences of RNs, GPs, and IPAV

 

T2

T0a, T2

T0a, T2

T0a, T2

CRF, questionnaires (Koverdem), minutes

 Micro: NHR level

Utilization of GP office (formal characteristics)

 

T0a, T2

Questionnaires (ZAP)

Family involvement in medical care

 

T0a, T2

Questionnaires (Koverdem)

 Multiple levels

Unmet implementation support needs (IPAV)

 

T1, T2

Questionnaires

Other factors (open-ended questions)

 

T0b, T1, T2

T0a, T2

T0a, T2

T0a, T2

T1, T2

Questionnaires, minutes

  1. Instruments: Zufriedenheit in der Arztpraxis (“Satisfaction in GPs office”, ZAP) [25]. Survey instruments of the research project “Optimization of the cooperation between general practitioners and home care services” Koverdem [26]. Measures of the European Project on Patient Evaluation of General Practice Care (EUROPEP) [27]. Measures of interprofessional collaboration designed for the pre-post evaluation study “Interdisciplinary Implementation of Quality Instruments for the Care of residents with Dementia in Nursing Homes” (InDemA) [28]. Normalization Measure Development QUES (NoMAD) [29, 30]. Partnership Self-Assessment Tool (PSAT) [31]. Jefferson Scale of Attitudes toward Physician–Nurse Collaboration [32]. Collaborative Practice Assessment Tool (CPAT) [33]. Practice Environment Scale of the Nursing Work Index (PES-NWI) [34, 35]
  2. Abbreviations: CRF case report form, GPs general practitioners, IPAVs interprof ACT agents, NHD nursing home directors, NHRs nursing home residents, T0a before randomization, T0b after randomization, (T0b) as participants and moderator of kick-off meeting, T1 follow-up after 6 months, T2 follow-up after 12 months, RNs registered nurses, STM study team member
  3. aSingle items or subscales of reported tools are used for the outcome domains in question. In addition, self-developed items are used for the measurement of all outcome domains