Adaptation
SIL
The PERFECT-ER implementation process was adapted significantly from that tested.…in the first sort of four or five months I had meetings with whatever staff I could grab …as time went on umm that got more and more difficult …staff movement …a lot of agency …pool staff (SIL, Ward B)Ward pressures impacted on staff and their ability to get together as a team as part of implementation. Rather, SILs adapted the process using senior individuals (such as ward managers or PLs) or people relevant to checklist elements (eg, physiotherapists for rehabilitation items) to facilitate action planning.I did manage to get some help from our orthogeriatrician [PL] …between the two of us we did a bit of a brainstorm on what we can implement (SIL, Ward D)Thus, SILs undertook action planning with ward opinion leaders, but the missing team approach to action planning probably impacted on ward staff opportunities for engagement.