Invest in implementing and monitoring evidence-based practices
Evidence-based practices (EBP) to achieve better outcomes for older people were well recognised, but poorly translated into practice. Barriers included lack of staff knowledge, lack of prioritisation by teaching and service organisations, resistance to change, and lack of investment in implementation and change management methods.
“It was interesting hearing all the research out there and all the money that’s been invested into research. It stops there and that’s the thing. There is so much stuff out there saying how we should be doing things. Then the next step is investing into implementing into practice.” P16, nurse, clinician
Translational efforts included credible experts from other organisations, local adaptation of guidelines and standardised orders, education and mentoring, and local data to prioritise issues and highlight gaps in EBP. These efforts were driven largely by informal leaders. Progress required champions willing to change practice, and continuing support and monitoring within the local context.
“I think in [ward name] the model works better because they’ve got such passionate and enthusiastic staff so they’re actually wanting to change the culture of how they care for older people.” P19, geriatrician, clinician “I think people [staff] will fall unless we really monitor, I think they’ll fall back to their old pattern.” P2, nurse, manager
Although several respondents appeared confident that organisational audits, incident monitoring and benchmarking processes provided appropriate data for monitoring care and outcomes of older patients, others were sceptical about data quality and use, and identified a lack of age-stratified reporting. They articulated that investment in targeted measurement was essential, needing staff with skills and dedicated time for reliable data collection and interpretation.
“They’d tell you how wonderful all their data is and how they collect all this data. To me it’s all smoke and mirrors. It’s a bit like quality and safety data… there’s not a lot of rigour in how it’s collected.” P12, nurse, academic