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Purpose <p>To explore barriers and facilitators to implementing a discharge preparation service program for older adults with multimorbidity, and to inform improvements in this service.</p> Methods <p>Using purposive sampling, we recruited 4 physicians, 14 nurses, 6 patients, and 6 caregivers for semi-structured interviews. The Consolidated Framework for Implementation Research (CFIR) guided the development of the interview guide and analysis. Inductive-deductive analyses were conducted.</p> Results <p>The findings encompassed 20 constructs across the four CFIR domains (Innovation, Outer Setting, Inner Setting, and Individuals), identifying 11 facilitators, 14 barriers, and 2 neutral factors. Key implementation facilitators included a reliable evidence base, favorable environmental conditions and resources, multidisciplinary team establishment, and leadership support. Primary barriers comprised intervention complexity, increased labor costs, incomplete policies and models, lack of financial incentives, and poor compliance.</p> Conclusion <p>In summary, this study comprehensively analyzed the potential influencing factors for implementing discharge preparation services for older adults with multimorbidity. Providing discharge preparation services for this population requires not only a solid evidence base, but also appropriate staffing, convenient and standardized workflows, enhanced training for service providers, and supportive policy and referral infrastructure. These findings advance our understanding of the multilevel conditions necessary for successful implementation of discharge preparation services in this population.</p>

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Barriers and facilitators to implementing discharge preparation services for older adults with multimorbidity: a qualitative study guided by the updated CFIR

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月8日

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  • Xing Wu,
  • Xu Yao,
  • Shanshan Dou,
  • Jiahui Lv,
  • Yajuan Feng,
  • Ru Zhang,
  • Ping Yan,
  • Xiuyan Ye,
  • Maidinaimu Nuermaimaiti

摘要

Purpose

To explore barriers and facilitators to implementing a discharge preparation service program for older adults with multimorbidity, and to inform improvements in this service.

Methods

Using purposive sampling, we recruited 4 physicians, 14 nurses, 6 patients, and 6 caregivers for semi-structured interviews. The Consolidated Framework for Implementation Research (CFIR) guided the development of the interview guide and analysis. Inductive-deductive analyses were conducted.

Results

The findings encompassed 20 constructs across the four CFIR domains (Innovation, Outer Setting, Inner Setting, and Individuals), identifying 11 facilitators, 14 barriers, and 2 neutral factors. Key implementation facilitators included a reliable evidence base, favorable environmental conditions and resources, multidisciplinary team establishment, and leadership support. Primary barriers comprised intervention complexity, increased labor costs, incomplete policies and models, lack of financial incentives, and poor compliance.

Conclusion

In summary, this study comprehensively analyzed the potential influencing factors for implementing discharge preparation services for older adults with multimorbidity. Providing discharge preparation services for this population requires not only a solid evidence base, but also appropriate staffing, convenient and standardized workflows, enhanced training for service providers, and supportive policy and referral infrastructure. These findings advance our understanding of the multilevel conditions necessary for successful implementation of discharge preparation services in this population.