“It was Like a Whole New World Opened Up”: Nursing Home Provider Perspectives on Implementing a Person-Centered Communication Intervention

This study assessed factors influencing implementation of Preferences for Activity and Leisure (PAL) Cards, a person-centered communication tool, in nursing homes. Provider champions (N=26) created PAL Cards for 15 to 20 residents as part of a quality improvement project and then they participated in exit interviews incorporating questions from the Consolidated Framework for Implementation Research domains of Characteristics of the Intervention and Process. The factors most frequently cited as facilitators were: Evidence Strength and Quality, Relative Advantage, Engaging, Executing, and Reflecting and Evaluating. Complexity and Cost were mentioned as barriers. Future implementation efforts should pursue flexible interventions in which staff can quickly see the value of their efforts, employ a team approach to implementation, and access external expert coaching models.