How to deal with context? A context-mapping tool for quality and safety in nursing homes and homecare (SAFE-LEAD Context).

We conducted a step-wise collaborative design process consisting of mapping of key contextual factors as perceived by managers in Norwegian nursing homes and homecare, then created a draft tool discussed in a consortium workshop with co-researchers, and ran an international cross-country comparison. The SAFE-LEAD Context tool is inspired by the Consolidated Framework for Implementation Research (CFIR). The tool incorporates factors describing the outer setting of nursing homes and homecare at the national and local levels, in addition to factors describing the inner setting. The tool is flexible yet more detailed than current frameworks and capable of grading and describing the included contextual factors over time in the nursing home and homecare settings. A systematic approach using the SAFE-LEAD Context tool will support and improve the understanding and evaluation of quality and safety improvement interventions.