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Randomized Controlled Trial
. 2022 Sep;70(9):2686-2694.
doi: 10.1111/jgs.17900. Epub 2022 Jun 9.

Dissemination of a successful dementia care program: Lessons to facilitate spread of innovations

David B Reuben  1 , Leslie Chang Evertson  1 , Rebecca Jackson-Stoeckle  2 , Gary Epstein-Lubow  3 , Lynn Hill Spragens  4 , Kristin Lees Haggerty  2 , Katherine Sy Serrano  1 , Lee A Jennings  5
Affiliations
Randomized Controlled Trial

Dissemination of a successful dementia care program: Lessons to facilitate spread of innovations

David B Reuben et al. J Am Geriatr Soc. 2022 Sep.

Abstract

Background: Despite the effectiveness of innovations to improve the care of persons with dementia, there has been limited diffusion of these into widespread clinical practice. We aimed to identify common barriers and address them directly in the initial phase of dissemination of a successful dementia care program.

Methods: Description of and early experience with a dissemination strategy of the UCLA Alzheimer's and Dementia Care Program to health care systems nationwide. We measured site-identified goals for the program and indicators of success, number of adopting sites, and participants in their programs.

Results: From January 2019 to December 2021, 80 sites expressed interest in adopting the program, 14 (18%) sites adopted it, and 10 of these sites have begun caring for patients. Another 4 sites have implemented the program as part of a randomized clinical trial. To date, over 1690 persons living with dementia and their caregivers have received Alzheimer's and Dementia Care (ADC) care at 14 adopting sites. Key lessons from the early dissemination efforts include the importance of identifying a strong product champion at the adopting site, creating a business case for adoption, training of clinical staff and adapting the model to fit local cultures and workflow, as well as recognizing the likely long length of time needed for the decision to adopt and implementation process.

Conclusions: Despite many obstacles to dissemination, with local champions and technical assistance, successful innovations in dementia care can be implemented in diverse health systems. The ability to adopt sites to bring the program to full scale and achieve comparable outcomes to the original program remains to be determined.

Keywords: Alzheimer's disease; advance practice providers; caregiver burden; co-management; collaborative care; dementia.

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Conflict of interest statement

Conflict of Interest: None

Figures

Figure 1.
Figure 1.
Interested and adopting sites LOA=letter of agreement Mailed = AGS mailed approximately 20,000 ADC Program postcards to AGS website users, both members and non-members. From that, 38 sites expressed interest and reached out to learn more about the ADC Program
Figure 2.
Figure 2.
Map of adopting sites See Supplemental Material for descriptions of sites and timelines for adoption.
Figure 3.
Figure 3.
Adopting Sites’ organizational goals for the program and indicators of success a Only JAHF adopting sites (N=14). Does not include D-CARE sites
See this image and copyright information in PMC

Comment in

  • Robotic-assisted collaborative care.
    Callahan CM, Unutzer J. Callahan CM, et al. J Am Geriatr Soc. 2022 Sep;70(9):2484-2486. doi: 10.1111/jgs.17934. Epub 2022 Jul 4. J Am Geriatr Soc. 2022. PMID: 35781250 No abstract available.

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