Developing and implementing a service charter for an integrated regional stroke service: an exploratory case study

Abstract

BackgroundBased on practices in commercial organizations and public services, healthcare organizations are using service charters to inform patients about the quality of service they can expect and to increase patient-centeredness. In the Netherlands, an integrated regional stroke service involving five organizations has developed and implemented a single service charter. The purpose of this study is to determine the organizational enablers for the effective development and implementation of this service charter.MethodsWe have conducted an exploratory qualitative study using Grounded Theory to determine the organizational enablers of charter development and implementation. Individual semi-structured interviews were held with all members of the steering committee and the taskforce responsible for the service charter. In these twelve interviews, participants were retrospectively asked for their opinions of the enablers. Interview transcripts have been analysed using Glaser’s approach of substantive coding consisting of open and selective coding in order to develop a framework of these enablers. A tabula rasa approach was used without any preconceived frameworks used in the coding process.ResultsWe have determined seven categories of enablers formed of a total of 27 properties. The categories address a broad spectrum of enablers dealing with the basic foundations for cooperation, the way to manage the project’s organization and the way to implement the service charter. In addition to the enablers within each individual organization, enablers that reflect the whole chain seem to be important for the effective development and implementation of this service charter. Strategic alignment of goals within the chain, trust between organizations, willingness to cooperate and the extent of process integration are all important properties.ConclusionsThis first exploratory study into the enablers of the effective development and implementation was based on a single case study in the Netherlands. This is the only integrated care chain using a single service charter that we could find. Nevertheless, the results of our explorative study provide an initial framework for the development and implementation of service charters in integrated care settings. This research contributes to the literature on service charters, on patient-centeredness in integrated care and on the implementation of innovations.

Clients satisfaction at primary healthcare facilities and its association with implementation of client service charter in Tanzania

“…A client service charter is a document that sets out information on the services provided , the standards of service that customers can expect from the facility , and how to make complaints or suggestions for improvement” [ 28 , 29 ]. Therefore, improved implementation of a patient/client-centred healthcare relies on display of the charter in various services delivery points, effective charter monitoring, and availability of a feedback and complaints handling system [ 24 ].…”

Alignment in implementation of evidence-based interventions: a scoping review

“…The remaining 20 included both structural and social alignment (Table 4, see also Additional file 5, column 3). Contrary to the focus of the main part of the 12 definitions of alignment (presented above), only 8 of the 53 articles focused only on alignment between inner and outer contextual elements of an organization or system with each other [31,36,37,[47][48][49][50][51]. For example, aligning leadership across organizational levels [47], or goals and cultures across organizations [37], were in these eight articles highlighted as important facilitators during implementation of the EBI.…”

“…However, a clear definition of alignment was seldom provided. Of the 53 included articles, 12 provided a definition of alignment [6,19,22,26,[29][30][31][32][33][34][35][36]. Six of the definitions were the authors' own (i.e., no reference where given), the other six provided a reference for their definition [19,22,29,33,35,36].…”

“…This category contains various strategic initiatives where alignment is part of improved care performance, for example to achieve coordination of change efforts [46] or to improve change management [65]. Data in this category consists of descriptions where alignment has contributed to improvement in healthcare [1,20,26,32,33,46,50,57,61,64,65,67,68] and/or where it is claimed that alignment was necessary in order to achieve improvements in healthcare [1,31,34,35,44,48]. In the original articles actors named as change management specialist, executive leader, executive director, leader, manager, project leader, project manager, senior leader, supervisor and unit heads were included as leaders in this review.…”

“…The term leader was used most frequently [1, 29, 30, 34-36, 47, 50, 52-54, 56] followed by manager [22,29,33,44,64,67,71]. For example, project leaders were said to have a crucial role in creating alignment [31,32,55] and managers were described as responsible for providing employees with motivation and enthusiasm in the alignment progress [31]. Harrison et al [53] emphasize that participation and support from upper management in a strategic initiative is key to align organizational priorities and O'Reilly et al [47] confirms that alignment of leadership across hierarchical levels is vital for successful implementation of a new strategic initiative.…”