Encouraging Best Practice in Residential Aged Care Program: Final Evaluation Report

13.2 - Recommendations arising from the program evaluation

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13.2 Recommendations arising from the program evaluation

The following recommendations are based on an underlying premise that there is a need to build on what has been learnt so that there is ongoing improvement of best practice in residential aged care.

To improve coordination, avoid duplication, facilitate consistency in the production of evidence and share knowledge about how best to implement evidence-based practice it is recommended that:
1. A central agency be established with responsibility for supporting the ongoing implementation of evidence-based practice in residential aged care. The agency should be funded by government but independent from government.

It is further recommended that the roles and responsibilities of this central agency include, but not be limited to:
2. Advising government and research funding bodies on opportunities to conduct primary research in residential aged care to fill gaps in current evidence.
3. Working with other agencies, including the Joanna Briggs Institute, to coordinate the synthesis of existing evidence into a form that can be applied in residential aged care. This should include a system of regular review and updating of the evidence.
4. Collaborating with existing networks and professional bodies involved in research and the application of research in residential aged care.
5. Disseminating existing evidence that is relevant to residential aged care.
6. Promoting the benchmarking of existing practices to identify opportunities for improvement.
7. Advising residential aged care providers on optimal strategies for implementing evidence-based practice.

To ensure ongoing links between the system of accreditation and use of evidence in residential aged care it is recommended that:
8. Accreditation surveyors, and the documentation which underpins their activities, support the ongoing use of the resources developed by the EBPRAC program and recommend use of those resources, where appropriate, during accreditation visits.
9. A mechanism be established whereby the latest evidence, and any resources to support the use of that evidence, can be used to inform the accreditation standards.

To develop clinical leaders who can support the ongoing implementation of evidence-based practice it is recommended that:
10. Consideration be given to the policy options for improving the leadership of middle managers in residential aged care, as set out in the paper by Jeon et al (Jeon, Glasgow et al. 2010).

To maximise the impact of what has been learnt to date from the EBPRAC program it is recommended that:
11. An editor be appointed to work with the lead organisations to prepare a suite of final reports that are consistent in style and quality. The reports could be published as a monograph series.
12. A central web-based repository be established and maintained which can act as a ‘one stop shop’ for resources (developed in EBPRAC or already available elsewhere) to support the implementation of evidence-based practice.
13. The work of the EBPRAC program be linked in some way with the current JBI COnNECT Aged Care website which already provides a mechanism for making the evidence to support clinical practice available to those working in residential aged care.
14. A dissemination plan be developed to promote the lessons learnt from the EBPRAC program, with a particular focus on how to reach staff working in residential aged care who do not access traditional mechanisms for dissemination (e.g. conferences, peer review publications).

With regard to the need for future projects within the EBPRAC program it is recommended that:
15. There is no need to fund more projects of a similar nature to those funded in Round 1 and Round 2. It would be preferable to invest in making the most of what has been learnt so far.
16. Funding should be allocated to identify a small number of ‘high impact changes’ that have the potential for maximum impact on quality of care, based on the available evidence. Indications on what some of those changes might be are to be found in the results of the EBPRAC projects.
17. Funding could then be allocated to the dissemination of the high impact changes throughout residential aged care i.e. a national approach.
18. If any projects similar to those in Round 1 and Round 2 are funded in the future consideration should be given to the intended outcomes. If the funded projects are to be replicated across the industry, then projects should be established to function in 'real world' conditions with the appropriate strategies and resources allocated to governance, implementation activities and evaluation
19. There is a place for high quality research about how best to implement evidence-based practice. An example is the use of local facilitators (champions), a large number of which were trained in the EBPRAC program, with differing roles and responsibilities. Identifying how best to select champions, how best to train champions, how best to support champions or even whether the champion model is effective at all, requires research to provide an answer.
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