ARCH Process Evaluation

We conducted a qualitative evaluation of the Addiction Recovery and Community Health (ARCH) team implementation processes (linked study to the ARCH Patient Outcomes Evaluation). ARCH is an addiction medicine consult team operating in the Royal Alexandra Hospital. Key stakeholder perspectives were sought to gain further insight on how the ARCH team was perceived, how they functioned, as well as how contextual factors influenced their impacts.

We adopted a focused ethnographic design and a patient-oriented approach. Semi-structured interviews were completed with ARCH patients, ARCH team members, internal stakeholders, and community stakeholders. Interview data was inductively analyzed to identify the positive impacts and key attributes of the ARCH team, as well as what ARCH could do to improve the care they deliver. We also mapped themes from ARCH team member interviews to implementation science frameworks (e.g., Consolidated Framework for Implementation Research and Theoretical Domains Framework) to guide future spread and scale of the intervention by other teams.

Overall, stakeholder responses were very positive. We found that the ARCH team was perceived as an outstanding team that is compassionate, accessible, honest, comprehensive, flexible, grassroots, and innovative. However, participants had concerns about the ARCH team’s service capacity, transitions involving community-based services, and ongoing resistance to harm reduction around the hospital. Based on these reservations, ARCH has refined its services to better suit stakeholder needs and continues to participate in quality improvement activities.

We hope that our findings will help inform the provision of similar addiction medicine teams in other acute care facilities.

Resources

Study Leads: Ginetta Salvalaggio (ARCH Evaluation PI) and Elaine Hyshka (Process Evaluation lead)

Funding Support: The Royal Alexandra Hospital Foundation (RAHF) and Alberta Innovates

Status: Complete