Integrating the Transitional Relationship Model into Clinical Practice

• Published in: Archives of psychiatric nursing Vol. 26; no. 5; pp. 374 - 381
• Main Authors: Forchuk, Cheryl, Martin, Mary-Lou, Jensen, Elsabeth, Ouseley, Susan, Sealy, Patricia, Beal, Georgiana, Reynolds, William, Sharkey, Siobhan
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2012; W.B. Saunders Company/JNL
• Subjects: Analysis of Variance; Best practice; Clinical medicine; Clinical practice; Community Mental Health Services - methods; Educational needs; Health Plan Implementation - methods; Hospitals; Hospitals, Psychiatric - organization & administration; Humans; Knowledge management; Linear Models; Models, Nursing; Nurse practitioners; Nurse-Patient Relations; Nursing; Ontario; Patient Discharge; Practice Guidelines as Topic; Psychiatric hospitals; Psychiatric-mental health nursing; Translation; Translational Medical Research - methods; Ontario; Canada
• DOI: 10.1016/j.apnu.2011.12.002
• ISSN: 0883-9417

Background: The challenge of facilitating knowledge translation in clinical practice includes enabling practitioners and agencies to implement a common set of best practices, such as the Transitional Relationship Model (TRM). In 1992, a participatory action project implemented the TRM on a long-term psychiatric hospital ward in Ontario, Canada. All participants were successfully “bridged” to the community. Despite positive outcomes associated with the TRM, implementation of any best practice is difficult because it involves changing processes. Objective: It was hypothesized that using multiple implementation strategies developed by wards that had already implemented the model would result in improved TRM implementation. Method: This study compared three groups of hospital wards; Group A wards had already adopted the TRM, Group B wards implemented the TRM in Year 1, and Group C wards implemented the TRM in Year 2. An iterative process was used in which strategies suggested by the A wards were used to enhance implementation on the B and C wards, respectively. These included enhancing staff participation, creating/maintaining supportive ward milieus, meeting specific educational needs, and supporting managers throughout the implementation process. The degree of actual implementation on each ward served as the primary outcome measure. Results: Group C implemented the TRM model significantly quicker than the other groups. Sustainability in the initial A wards required the implementation of additional strategies used by the later wards.