Evaluation of the Encouraging Better Practice in Aged Care (EBPAC) Initiative Final Report
Evaluation of the Encouraging Better Practice in Aged Care (EBPAC) InitiativeFinal Report
July 2015
Centre for Health Service Development
36543265-1
Dave Fildes
Anita Westera
Malcolm Masso
Rob Gordon
Pam Grootemaat
Kate Williams
Darcy Morris
Conrad Kobel
Peter Samsa
Suggested citation:
Fildes D, Westera A and Masso M, et al. (2015) Evaluation of the Encouraging Better Practice in Aged Care (EBPAC) Initiative: Final Report. Centre for Health Service Development, Australian Health Services Research Institute, University of Wollongong.
Table of Contents
Key messagesi
Executive summaryii
1INTRODUCTION1
1.1Background to the EBPAC Program1
1.2Links between the current program and earlier rounds1
1.3EBPAC and ASCIHAG Objectives1
1.3.1Improvements for recipients of aged care services2
1.3.2Improvements for staff2
1.3.3System improvements2
1.4Individual project aims and objectives3
1.5Targeted literature review4
2EVALUATION METHODOLOGY6
2.1The CHSD Evaluation Framework6
2.2Evaluation approach7
2.2.1Tool 1 Project six monthly report8
2.2.2Tool 2 Project expenditure breakdown report8
2.2.3Tool 3 Project dissemination log8
2.2.4Tool 4 Training materials evaluation questionnaire8
2.2.5Tool 5 Project workshop log9
2.2.6Tool 6 Project workshop notification/recruitment tool9
2.2.7Tool 7 Stakeholder interviews9
2.2.8Other evaluation activities9
2.3Evaluation of the national roll-out projects10
2.3.1National roll-out interviews11
2.3.2National roll-out interviews sampling method12
2.3.3National roll-out surveys13
2.3.4Evaluation of remaining EBPAC projects14
3PROJECT DELIVERY16
3.1Project groupings16
3.2Project evidence17
3.3Project implementation18
3.3.1Implementation strategies19
3.3.2Development of resources21
3.4Leadership and change projects21
3.4.1Leadership and change project implementation22
3.4.2Leadership and change projects resource development23
3.4.3Enablers23
3.4.4Barriers25
3.4.5Delays experienced25
3.5Community care projects25
3.5.1Enablers and barriers28
3.5.2Delays experienced34
3.6National roll-out projects34
3.7Comparison with Round 1 and Round 237
4PROJECT IMPACT38
4.1Impact and outcomes on consumers38
4.1.1Consumer impacts and outcomes: Leadership and change projects38
4.1.2Consumer impacts and outcomes: Community care projects39
4.1.3Consumer impacts and outcomes: National roll-out projects41
4.2Impact and outcomes on providers42
4.2.1Provider impacts and outcomes: Leadership and change projects42
4.2.2Provider impacts and outcomes: Community care projects44
4.2.3Provider impacts and outcomes: National roll-out projects47
4.3Impact and outcomes on the aged care system48
4.3.1System impacts and outcomes: Leadership and change projects49
4.3.2System impacts and outcomes: Community care projects52
4.3.3System impacts and outcomes: National roll-out projects55
5COSTING ANALYSIS58
5.1Cost implications of leadership and change projects58
5.2Cost implications of community care projects60
5.3Cost implications of national roll-out projects61
5.4Summary63
6GENERALISABILITY64
6.1Leadership and change projects64
6.2Community projects66
6.3National roll-out projects68
7SUSTAINABILITY69
7.1Factors that promote sustainability69
7.2Sustaining benefits for consumers and stakeholders72
7.2.1Sustaining community care project benefits72
7.2.2Sustaining national roll-out project benefits73
7.3Continuing the activities73
7.3.1Continuing the activities of community care projects73
7.3.2Continuing the activities of national roll-out project75
7.4Continuing the new processes75
7.4.1Continuing the processes of leadership and change projects76
7.4.2Continuing the processes of community care projects78
7.4.3Continuing the processes of national roll-out projects80
8DISSEMINATION82
8.1Type of dissemination82
8.2Purpose of dissemination83
8.3Follow up after dissemination84
8.4Effectiveness of dissemination85
8.5Summary86
9DISCUSSION88
9.1What was achieved?88
9.2Program objectives89
9.3The science of implementation92
10CONCLUSION AND RECOMMENDATIONS96
APPENDIX 1 - TARGETED LITERATURE REVIEW98
APPENDIX 2 - PROJECT SUMMARIES101
APPENDIX 3 - NATIONAL ROLL-OUT PROJECTS: STAKEHOLDER INTERVIEW REPORT114
APPENDIX 4 - NATIONAL ROLL-OUT PROJECTS: SURVEY ANALISYS148
APPENDIX 5 - CHAMPIONS FOR SKIN INTEGRITY (CSI) SURVEY161
APPENDIX 6 - PALLIATIVE APPROACH TOOLKIT SURVEY164
List of Tables
Table 1Projects funded under the EBPAC and ACSIHAG initiatives3
Table 2Sampling methodology for telephone interviews13
Table 3Number of interviews carried out14
Table 4Evidence base for each project17
Table 5Implementation strategies and practice changes, leadership and change projects22
Table 6Resources developed by leadership and change projects23
Table 7Implementation strategies and practice changes, community projects26
Table 8Resources developed by community projects27
Table 9Impact on use of evidence, community projects28
Table 10Main factors influencing implementation, community care projects28
Delays to implementation, community projects34
Table 12Location of workshops and facilities represented at workshops, national roll-out projects35
Table 13Responses to survey of participants, national roll-out projects36
Table 14Resources developed by the national roll-out projects36
Table 15Consumer impacts and outcomes: Leadership and change projects38
Table 16Consumer impacts and outcomes: Community care projects39
Table 17Consumer impacts and Outcomes: National roll-out projects41
Table 18Provider impacts and outcomes: Leadership and change projects42
Table 19Provider impacts and outcomes: Community care projects45
Table 20Provider impacts and outcomes: National roll-out projects47
Table 21System activities and outcomes: Leadership and change projects49
Table 22System activities and outcomes: community care projects52
Table 23System activities and outcomes: national roll-out projects55
Table 24Leadership and change projects, expenditure and funding59
Table 25Community care projects, expenditure and funding61
Table 26National roll-out projects, expenditure and funding62
Table 27Generalisability community projects67
Table 28Type of dissemination by number and proportion82
Table 29Dissemination activities by purpose of dissemination83
Table 30Dissemination activities by follow-up received85
Table 31Dissemination activities by effectiveness rating86
Table 32EBPAC objectives90
Table 33EBPAC projects and EPOC taxonomy of interventions93
Table 34Participants by state, location and size of RACF115
List of Figures
Figure 1CHSD Evaluation Framework7
Figure 2Main focus of activity of EBPAC projects according to the CHSD evaluation framework16
Figure 3Number of clients involved in each community project27
Figure 4A multi-level framework predicting implementation outcomes92
Abbreviations used in this report
Acronyms
Descriptions
ACSIHAG
Aged Care Services Improvement Healthy Ageing Grant
BHS
Ballarat Health Services
CALD
Culturally and Linguistically Diverse
CHSD
Centre for Health Service Development, University of Wollongong
DoHA (the Department)
Commonwealth Department of Health and Aging
EBP
Evidence Based Practice
EBPAC
Encouraging Best Practice in Aged Care
EBPRAC
Establishing Best Practice in Residential Aged Care
INTVWs
Interviews
LEAP
The Lifestyle Engagement and Activity Program
LUPP
Leg Ulcer Prevention Program
RACF
Residential Aged Care Facility
RACP
Registered Aged Care Provider
SAP
Skin Awareness Program
TRACS
Teaching and Research Aged Care Services
Abbreviations for EBPAC projects
Acronyms
Descriptions
CL1
Bridging the Leadership Skill Gap
CL2
Clinical Mentoring: From Evidence-Base To Outcomes For Older People
CC1
Better Practice For Older People Living With Or At Risk Of Chronic Wounds In The Community
CC2
The Lifestyle Engagement And Activity Program (LEAP) For Life Project (Social Engagement And Physical Activity)
CC3
Home-Based Preferred Music Listening Program
CC4
CHOICES In CDC Aged Care
CC5
Building Better Oral Health Communities
CC6
Person-Centred Dementia Support In The Community
RC1
National Implementation Of The Palliative Approach Toolkit For Residential Aged Care Facilities
RC2
National Rollout of the Evidence Based Champions for Skin Integrity Program
RC3
The Sustainable Culture Change In Residential Aged C
