Barriers and facilitators to implement innovations in Canadian long-term care facilities: a longitudinal study of organizational readiness for knowledge translation.

Abstract

Background: The COVID-19 pandemic negatively affected residents of long-term care facilities (LTCFs). This situation highlighted the necessity to translate evidence-based policies and practices into this setting. However, implementing innovations represents a challenge for LTCFs. This study aims to identify the facilitators and barriers to the implementation of innovations in Canadian LTCFs.

Methods: We conducted a longitudinal correlational study involving different LTCFs participants and the use of the Organizational Readiness for Knowledge Translation (OR4KT) measurement tool before and after the implementation of an innovation. Only data collected at T1 were considered in the analysis due to the low response rate obtained at T2. A mixed-model effect with a random effect for LTCFs was used to account for within organization dependency on responses.

Results: In total, 256 respondents from 55 (60.4%) LTCFs participated in the study of which 107 participants were high and middle-level managers, and 149 were non-managerial staff. Variations in OR4KT scores were explained by some organizational factors. The province of location of the LTCF emerged as a significant factor for five subscales of the OR4KT as well as for the total score. The presence of a medical director and belonging to a chain (an organization with multiple LTCFs) seemed to be associated with higher OR4KT scores.

Conclusion: Successful LTCF innovation implementation may rely on the geographical administration of healthcare (e.g., the province), the presence of a medical director and the organizational contextual factors between the different actors of LTCFs and the health system.