Facilitators and challenges in the implementation of the Care Ecosystem at six clinical sites in the United States: A qualitative study

Abstract

INTRODUCTION: Collaborative care models with care navigation bridge medical and social needs in dementia care. These models, including the Care Ecosystem (CE), are being implemented at health systems and community-based programs across the United States. METHODS: Interdisciplinary team members from six early adopter CE programs were interviewed about the facilitators and challenges they faced implementing the CE. Interviews were analyzed thematically. RESULTS: Implementation facilitators included the presence of a champion or visionary, a clinical team with expertise in dementia, easy access to CE care protocols and consultative support, and flexibility in being able to modify the program to meet site-specific needs. Challenges centered on program launch, personnel turnover, reaching people from historically marginalized communities or those facing structural barriers to care, and program sustainability. DISCUSSION: This study provides practical information to guide successful implementation of effective dementia care from research to practice. Highlights: Collaborative care models with care navigation bridge medical and social needs in dementia care. Implementation facilitators included a champion, an expert clinical team, and flexibility. Challenges included program launch, personnel turnover, and program sustainability. Findings can guide implementation of effective dementia care from research to practice.