Improving health care quality requires effective and timely spread of innovations that support evidence- informed practices. However, implementing and spreading best practices in health care organizations involves time-consuming, complex, and resource-intensive processes. Understanding how to rapidly and effectively spread innovations in and across complex organizations is vital to improving the quality of health care delivery and effectively using scarce resources.
A Definition of the ‘Spread Process’
The ‘spread process’ is the idea that organizations spread, be in the process of spreading, or plan to spread tools and processes related to home care best practices within their organization. Although there are no widely agreed on definitions of the terms spread and scale-up, it has been suggested that scale-up is more commonly used in international health while spread is used more frequently to refer to improvement changes in high-income countries.
Spread Process Frameworks
One of the spread process frameworks is focused on community-based reproductive health service innovations in Asia, Africa, and South America. Another framework is used to spread operational changes to improve access for veterans to primary care and specialty outpatient clinics[]. Some of the common concepts in these two spread frameworks include (a) the identification of a new practice, (b) leadership support, (c) organizational support, (d) communication of the innovation, (e) measurement and feedback, and (f) social, cultural, political, and economic contexts within which spread occurs. These frameworks are focused on health innovations in community settings, but not specifically in home care. However, we believe it is reasonable that within both frameworks home care organizations of any size can find useful information to help improve the quality of their services.
What Does This Have To Do With Home Care?
There is strong rationale for a focus on spread in home care settings. The proportion of older adults in the population is escalating worldwide and is associated with an increasing demand for and use of home care services []. Older adults, the largest users of home care, often have multiple chronic conditions including dementia and are particularly vulnerable to negative health impacts such as hospitalization []. Home care contributes to the quality of life and functional health status of individuals while also replacing expensive hospital care with client-preferred care in the home []. Finally, home care organizations experience unique challenges in care provision including wide geographical service areas, high turnover, and inadequate funding [].
References
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