Encouraging Best Practice in Residential Aged Care Program: Final Evaluation Report
3.6 - Demonstrable benefit
- Key Messages
- Executive Summary
- About This Report
1 - Introduction- 2 - Evidence, Changes in Practice and the EBPRAC Program
3 - Program Delivery/Implementation- 3.1 - Introduction
- 3.2 - Implementation delays
- 3.3 - Model of change/implementation
- 3.4 - The nature of the changes in practice
- 3.5 - Context for change
- 3.6 - Demonstrable benefit
- 3.7 - Adequate resources
- 3.8 - Systems and use of data to support the use of evidence
- 3.9 - Stakeholder engagement, participation and commitment
- 3.10 - Key success factors - perceptions of lead organisations and facility staff
- 3.11 - Summary - incentives and barriers to sustained implementation
- 4 - Program Impact
- 5 - Capacity Building
- 6 - Generalisability
- 7 - Sustainability
- 8 - Dissemination
- 9 - Appropriateness
- 10 - Cost Implications for Government and Aged Care Providers
- 11 - Perceptions of High-Level Stakeholders
- 12 - Discussion and Conclusions
- 13 - Recommendations
- References
- Appendices 1 to 6
- Appendices 7 to 12
- Appendices 13 to 17
There is some evidence that if the benefits of a new practice are ‘visible’ then that practice will be adopted more easily (Greenhalgh, Robert et al. 2004) and there were many examples in the EBPRAC projects of demonstrable benefits providing positive reinforcement for changes that were being made. The type of benefits that are ‘visible’ manifested in various ways, including improved outcomes for residents:
These people had been completely reluctant up to that point in time about the whole benefit of the project. They saw this one wound heal and it was like the light went on and they went ‘oh I get it’. (P)
It’s a much more calmer environment. The staff are now really embracing, engaging with the residents and their families. There’s been improved family involvement. (F)
I can see the residents are much happier. (F)
improved systems of working (in examples from two of the palliative care projects):
I think the pathway was a much better way of doing it. (F)
Everything’s heaps more structured. It’s got a beginning and an end. (F)
benefits for staff:
They can see the benefits … they find that because they’re using these interventions, and they’re using them every day, they have got more time. (F)
or a more general sense that something positive has taken place:
I think the key thing was they started seeing results. They started seeing changes. (F)
Staff report that the relationships that they have with the family after a palliative care case conference are far better and things are far easier and there’s less complaints. (P)
Instances of ‘seeing’ the benefits can serve to reinforce that ‘what we were doing was right’ and prompt the introduction of further changes. Underpinning these different forms of benefits is the idea that something is ‘working’, even if it is unclear what it is that is working. This is well captured by the following comment in response to a question about the importance of being able to see that something ‘works’:
I think that’s extremely important to them, and that’s the clincher. They’re more willing to try it and try even in a different way – like they’ll try new things if they know that that thing worked. I think that’s really, really, important. (P)
The importance of this factor was illustrated at one of the EBPRAC national workshops when participants from 60 residential aged care facilities ranked ‘demonstrable benefits’ as the third most important factor influencing the implementation of evidence-based practice (see Appendix 15).
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