Factors influencing sustainability and scale-up of rural primary healthcare memory clinics: perspectives of clinic team members

BMC Health Services Research

Chelsie Cameron¹  Valerie Elliot¹  Melanie Bayly¹  Julie Kosteniuk¹  Debra Morgan¹  Dallas Seitz²  Megan E. O’Connell³  Amanda Froehlich Chow⁴ 

[1] Canadian Centre for Health & Safety in Agriculture, University of Saskatchewan, 104 Clinic Place, S7N 2Z4, Saskatoon, SK, Canada;Department of Psychiatry, Hotchkiss Brain Institute, and O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Room 2919 Health Sciences Centre, 3330 Hospital Drive NW, T2N 4N1, Calgary, AB, Canada;Department of Psychology, University of Saskatchewan, Arts 182, 9 Campus Drive, S7N 5A5, Saskatoon, SK, Canada;School of Public Health, University of Saskatchewan, 104 Clinic Place, S7N 2Z4, Saskatoon, SK, Canada;

关键词: Sustainability;    Spread;    Scaling up;    Primary healthcare;    Memory clinic;    Rural;    Dementia;   

DOI  :  10.1186/s12913-022-07550-0

来源: Springer

【 摘 要 】

BackgroundThe aging of rural populations contributes to growing numbers of people with dementia in rural areas. Despite the key role of primary healthcare in rural settings there is limited research on effective models for dementia care, or evidence on sustaining and scaling them. The purpose of this study was to identify factors influencing sustainability and scale-up of rural primary care based memory clinics from the perspective of healthcare providers involved in their design and delivery.MethodsParticipants were members of four interdisciplinary rural memory clinic teams in the Canadian province of Saskatchewan. A qualitative cross-sectional and retrospective study design was conducted. Data were collected via 6 focus groups (n = 40) and 16 workgroup meetings held with teams over 1 year post-implementation (n = 100). An inductive thematic analysis was used to identify themes.ResultsEleven themes were identified (five that influenced both sustainability and scale-up, three related to sustainability, and three related to scale-up), encompassing team, organizational, and intervention-based factors. Factors that influenced both sustainability and scale-up were positive outcomes for patients and families, access to well-developed clinic processes and tools, a confident clinic leader-champion, facilitation by local facilitators and the researchers, and organizational and leadership support. Study findings revealed the importance of particular factors in the rural context, including facilitation to support team activities, a proven ready-to-use model, continuity of team members, and mentoring.ConclusionsInterdisciplinary models of dementia care are feasible in rural settings if the right conditions and supports are maintained. Team-based factors were key to sustaining and scaling the innovation.

【 授权许可】

CC BY