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Self-Organization of Interprofessional Staff to Improve Mobility of Hospitalized Patients with STRIDE: a Complexity Science-Informed Qualitative Study.

Publication ,  Journal Article
Bruening, RA; Sperber, N; Wang, V; Mahanna, E; Choate, A; Tucker, M; Zullig, LL; Van Houtven, CH; Allen, KD; Hastings, SN
Published in: J Gen Intern Med
December 2022

BACKGROUND: Inpatient mobility programs can help older adults maintain function during hospitalization. Changing hospital practice can be complex and require engagement of various staff levels and disciplines; however, we know little about how interprofessional teams organize around implementing such interventions. Complexity science can inform approaches to understanding and improving multidisciplinary collaboration to implement clinical programs. OBJECTIVE: To examine, through a complexity science lens, how clinical staff's understanding about roles in promoting inpatient mobility evolved during implementation of the STRIDE (assiSTed eaRly mobIlity for hospitalizeD older vEterans) hospital mobility program. DESIGN: Qualitative study using semi-structured interviews. PARTICIPANTS: Ninety-two clinical staff at eight Veterans Affairs hospitals. INTERVENTIONS: STRIDE is a supervised walking program for hospitalized older adults designed to maintain patients' mobility and function. APPROACH: We interviewed key staff involved in inpatient mobility efforts at each STRIDE site in pre- and post-implementation periods. Interviews elicited staff's perception of complexity-science aspects of inpatient mobility teams (e.g., roles over time, team composition). We analyzed data using complexity science-informed qualitative content analysis. KEY RESULTS: We identified three key themes related to patterns of self-organization: (1) individuals outside of the "core" STRIDE team voluntarily assumed roles as STRIDE advocates, (2) leader-champions adapted their engagement level to match local implementation team needs during implementation, and (3) continued leadership support and physical therapy involvement were key factors for sustainment. CONCLUSIONS: Staff self-organized around implementation of a new clinical program in ways that were responsive to changing program and contextual needs. These findings demonstrate the importance of effective self-organization for clinical program implementation. Researchers and practitioners implementing clinical programs should allow for, and encourage, flexibility in staff roles in planning for implementation of a new clinical program, encourage the development of advocates, and engage leaders in program planning and sustainment efforts.

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Published In

J Gen Intern Med

DOI

EISSN

1525-1497

Publication Date

December 2022

Volume

37

Issue

16

Start / End Page

4216 / 4222

Location

United States

Related Subject Headings

  • Veterans Health
  • Veterans
  • United States Department of Veterans Affairs
  • United States
  • Qualitative Research
  • Leadership
  • Humans
  • General & Internal Medicine
  • Aged
  • 4206 Public health
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Bruening, R. A., Sperber, N., Wang, V., Mahanna, E., Choate, A., Tucker, M., … Hastings, S. N. (2022). Self-Organization of Interprofessional Staff to Improve Mobility of Hospitalized Patients with STRIDE: a Complexity Science-Informed Qualitative Study. J Gen Intern Med, 37(16), 4216–4222. https://doi.org/10.1007/s11606-022-07482-9
Bruening, Rebecca A., Nina Sperber, Virginia Wang, Elizabeth Mahanna, Ashley Choate, Matthew Tucker, Leah L. Zullig, Courtney Harold Van Houtven, Kelli D. Allen, and Susan N. Hastings. “Self-Organization of Interprofessional Staff to Improve Mobility of Hospitalized Patients with STRIDE: a Complexity Science-Informed Qualitative Study.J Gen Intern Med 37, no. 16 (December 2022): 4216–22. https://doi.org/10.1007/s11606-022-07482-9.
Bruening RA, Sperber N, Wang V, Mahanna E, Choate A, Tucker M, et al. Self-Organization of Interprofessional Staff to Improve Mobility of Hospitalized Patients with STRIDE: a Complexity Science-Informed Qualitative Study. J Gen Intern Med. 2022 Dec;37(16):4216–22.
Bruening, Rebecca A., et al. “Self-Organization of Interprofessional Staff to Improve Mobility of Hospitalized Patients with STRIDE: a Complexity Science-Informed Qualitative Study.J Gen Intern Med, vol. 37, no. 16, Dec. 2022, pp. 4216–22. Pubmed, doi:10.1007/s11606-022-07482-9.
Bruening RA, Sperber N, Wang V, Mahanna E, Choate A, Tucker M, Zullig LL, Van Houtven CH, Allen KD, Hastings SN. Self-Organization of Interprofessional Staff to Improve Mobility of Hospitalized Patients with STRIDE: a Complexity Science-Informed Qualitative Study. J Gen Intern Med. 2022 Dec;37(16):4216–4222.
Journal cover image

Published In

J Gen Intern Med

DOI

EISSN

1525-1497

Publication Date

December 2022

Volume

37

Issue

16

Start / End Page

4216 / 4222

Location

United States

Related Subject Headings

  • Veterans Health
  • Veterans
  • United States Department of Veterans Affairs
  • United States
  • Qualitative Research
  • Leadership
  • Humans
  • General & Internal Medicine
  • Aged
  • 4206 Public health