Maximising Embedded pharmacists in aGed cAre Medication Advisory Committees (MEGA-MAC): implementing Australia’s new Guiding Principles for Medication Management in Residential Aged Care Facilities using a knowledge broker and national quality improvement collaborative intervention.

This trial will evaluate a multifactorial intervention to implement the Commonwealth of Australia (Department of Health and Aged Care) Guiding Principles for Medication Management in Residential Aged Care Facilities (Guiding Principles) in Australian residential aged care facilities (RACFs). This is a RACF-level intervention. Each RACF will receive the intervention for nine months. The intervention involves a knowledge broker dyad (pharmacist and Medication Advisory Committee [MAC] representative) who will develop, implement and evaluate RACF-specific local action plans to implement the Guiding Principles. Knowledge brokers are individuals or groups that help to move knowledge from those who create the knowledge to those that use the knowledge. The knowledge broker dyad will be supported by a national quality improvement collaborative, called the MEGA-MAC collaborative. The knowledge broker dyad will consist of: * A registered pharmacist working on-site at the RACF. The pharmacist will be responsible for leading the knowledge broker dyad and will spend 4.5 hours per RACF per week on the intervention. * A healthcare professional MAC representative (chair or member of the MAC) who provides services to the RACF. The MAC representative will spend 1.5 hours per RACF per week supporting the pharmacist to deliver the intervention. The knowledge broker pharmacist may work at one participating RACF or multiple participating RACFs. In the latter case, the knowledge broker pharmacist may collaborate with a different MAC representative for each RACF, the same MAC representative for all the RACFs the MAC governs, or a mixture of both. The knowledge broker dyads will be trained to deliver the intervention. Training will involve completing a series of self-paced education modules that will take approximately 4 hours in total. Training will be developed by the Project Management Team and will be made available to the knowledge broker dyads within 4 weeks of commencing the intervention. The education modules will cover topics on medication safety and the quality use of medicines in Australian residential aged care, the Guiding Principles, the MEGA-MAC study design and knowledge translation (e.g. local actions plans, how to be a knowledge broker). The MEGA-MAC collaborative will act as a real-time clinical network to facilitate sharing of experience and expertise between the knowledge broker dyads at each RACF and support the knowledge broker dyads, RACFs, MACs and aged care provider organisations to implement the Guiding Principles into practice. The MEGA-MAC collaborative will be supported by a panel of clinical experts, implementation scientists and consumer representatives. The MEGA-MAC collaborative will conduct quarterly virtual ‘MEGA-MAC’ meetings (baseline, 3, 6 and 9 months), distribute quarterly ‘MEGA-MAC’ newsletters (baseline, 3, and 6 months), provide expert and peer review feedback on the knowledge broker dyads’ local action plans (baseline, 3 months and at 6 months), and offer ongoing ad-hoc expert and peer support via virtual meetings. ‘MEGA-MAC’ meetings will be approximately one hour in duration and all knowledge broker dyads participating in the intervention will be invited to attend. Ongoing fidelity of the intervention delivered by the knowledge broker dyads will be monitored using the local action plans, the MEGA-MAC collaborative meetings and monthly meetings with the Project Management Team.