David B Reuben1, Leslie Chang Evertson1, Rebecca Jackson-Stoeckle2, Gary Epstein-Lubow3, Lynn Hill Spragens4, Kristin Lees Haggerty2, Katherine Sy Serrano1, Lee A Jennings5. 1. Multicampus Program in Geriatric Medicine and Gerontology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA. 2. Education Development Center, Inc., Waltham, Massachusetts, USA. 3. Alpert Medical School of Brown University, Providence, Rhode Island, USA. 4. Spragens & Associates, LLC, Durham, North Carolina, USA. 5. Section of Geriatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
Abstract
BACKGROUND: Despite the effectiveness of innovations to improve the care of persons with dementia, there has been limited diffusion of these into widespread clinical practice. We aimed to identify common barriers and address them directly in the initial phase of dissemination of a successful dementia care program. METHODS: Description of and early experience with a dissemination strategy of the UCLA Alzheimer's and Dementia Care Program to health care systems nationwide. We measured site-identified goals for the program and indicators of success, number of adopting sites, and participants in their programs. RESULTS: From January 2019 to December 2021, 80 sites expressed interest in adopting the program, 14 (18%) sites adopted it, and 10 of these sites have begun caring for patients. Another 4 sites have implemented the program as part of a randomized clinical trial. To date, over 1690 persons living with dementia and their caregivers have received Alzheimer's and Dementia Care (ADC) care at 14 adopting sites. Key lessons from the early dissemination efforts include the importance of identifying a strong product champion at the adopting site, creating a business case for adoption, training of clinical staff and adapting the model to fit local cultures and workflow, as well as recognizing the likely long length of time needed for the decision to adopt and implementation process. CONCLUSIONS: Despite many obstacles to dissemination, with local champions and technical assistance, successful innovations in dementia care can be implemented in diverse health systems. The ability to adopt sites to bring the program to full scale and achieve comparable outcomes to the original program remains to be determined.
BACKGROUND: Despite the effectiveness of innovations to improve the care of persons with dementia, there has been limited diffusion of these into widespread clinical practice. We aimed to identify common barriers and address them directly in the initial phase of dissemination of a successful dementia care program. METHODS: Description of and early experience with a dissemination strategy of the UCLA Alzheimer's and Dementia Care Program to health care systems nationwide. We measured site-identified goals for the program and indicators of success, number of adopting sites, and participants in their programs. RESULTS: From January 2019 to December 2021, 80 sites expressed interest in adopting the program, 14 (18%) sites adopted it, and 10 of these sites have begun caring for patients. Another 4 sites have implemented the program as part of a randomized clinical trial. To date, over 1690 persons living with dementia and their caregivers have received Alzheimer's and Dementia Care (ADC) care at 14 adopting sites. Key lessons from the early dissemination efforts include the importance of identifying a strong product champion at the adopting site, creating a business case for adoption, training of clinical staff and adapting the model to fit local cultures and workflow, as well as recognizing the likely long length of time needed for the decision to adopt and implementation process. CONCLUSIONS: Despite many obstacles to dissemination, with local champions and technical assistance, successful innovations in dementia care can be implemented in diverse health systems. The ability to adopt sites to bring the program to full scale and achieve comparable outcomes to the original program remains to be determined.
Authors: Barbara G Vickrey; Brian S Mittman; Karen I Connor; Marjorie L Pearson; Richard D Della Penna; Theodore G Ganiats; Robert W Demonte; Joshua Chodosh; Xinping Cui; Stefanie Vassar; Naihua Duan; Martin Lee Journal: Ann Intern Med Date: 2006-11-21 Impact factor: 25.391
Authors: Christopher M Callahan; Malaz A Boustani; Frederick W Unverzagt; Mary G Austrom; Teresa M Damush; Anthony J Perkins; Bridget A Fultz; Siu L Hui; Steven R Counsell; Hugh C Hendrie Journal: JAMA Date: 2006-05-10 Impact factor: 56.272
Authors: Lee A Jennings; Zaldy Tan; Neil S Wenger; Erin A Cook; Weijuan Han; Heather E McCreath; Katherine S Serrano; Carol P Roth; David B Reuben Journal: J Am Geriatr Soc Date: 2016-06-29 Impact factor: 5.562
Authors: Lee A Jennings; Alison M Laffan; Anna C Schlissel; Erin Colligan; Zaldy Tan; Neil S Wenger; David B Reuben Journal: JAMA Intern Med Date: 2019-02-01 Impact factor: 21.873
Authors: David B Reuben; Zaldy S Tan; Tahmineh Romero; Neil S Wenger; Emmett Keeler; Lee A Jennings Journal: J Am Geriatr Soc Date: 2019-07-29 Impact factor: 5.562
Authors: David B Reuben; Thomas M Gill; Alan Stevens; Jeff Williamson; Elena Volpi; Maya Lichtenstein; Lee A Jennings; Zaldy Tan; Leslie Evertson; David Bass; Lisa Weitzman; Martie Carnie; Nancy Wilson; Katy Araujo; Peter Charpentier; Can Meng; Erich J Greene; James Dziura; Jodi Liu; Erin Unger; Mia Yang; Katherine Currie; Kristin M Lenoir; Aval-NaʼRee S Green; Sitara Abraham; Ashley Vernon; Rafael Samper-Ternent; Mukaila Raji; Roxana M Hirst; Rebecca Galloway; Glen R Finney; Ilene Ladd; Alanna Kulchak Rahm; Pamela Borek; Peter Peduzzi Journal: J Am Geriatr Soc Date: 2020-10-06 Impact factor: 5.562
Authors: Kristin Lees Haggerty; Randi Campetti; Rebecca Jackson Stoeckle; Gary Epstein-Lubow; Leslie Chang Evertson; Lynn Spragens; Katherine Sy Serrano; Lee A Jennings; David B Reuben Journal: J Am Geriatr Soc Date: 2022-05-25 Impact factor: 7.538