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The pilot study also resulted in recommendations for a nationwide implementation of the instruments for comparative studies among nursing homes, residential homes and homecare institutions.
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The transference and implementation of the instrument content to an electronic format is the full responsibility of the licensee.
In addition, the SHELTER study tests the implementation of the instrument on a large scale, leading to the creation of a unique database.
As the design and implementation of the instrument will involve financial and normative decisions, a range of actors will be involved.
Research tells us that the inclusion of different stakeholders in a Delphi procedure promotes acceptance of feedback and effective implementation of the instrument [ 38].
However, the implementation of these instruments is a complex issue.
However, public support for environmental taxes is often low, making the implementation of these instruments politically challenging in some settings.
Whether the implementation of these instruments leads to better outcomes is not fully established.
Scant studies have been published on the implementation of these instruments in Spain.
First, due to gradual implementation of the interRAI instruments, some provinces had more historical interRAI data than others, which makes the provincial prevalence estimates given by some scenarios not comparable.
To gain more information about the construction and implementation of the test instrument, see Schumann and Eberle (2014), Schumann and Eberle (2011), Schumann et al. (2011) and Schumann et al. (2010).
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