Evaluating Implementation of the Diabetes Perioperative Passport: A qualitative focus group study

Abstract

AimsTo examine the factors affecting implementation of an empowerment tool for patients with diabetes in two surgical groups within a single district general hospitalBackgroundA perioperative passport was developed to improve care of people with diabetes undergoing elective surgery by equipping patients with a hand-held summary of their care needs. Two surgical groups were approached to be involved in developing and piloting this novel technology with contrasting results. DesignA qualitative study using focus groups to examine factors affecting staff engagement in implementing the diabetes perioperative passport.MethodsTwo focus group were conducted in 2017 with pre-operative nurses in the departments of orthopaedics and general surgery of an NHS trust (N= 8). Audio-taped group discussions were transcribed, and the data coded and analysed to identify themes.FindingsThe general surgical nurse group generally supported each other’s views and comments. They were enthused about the passport throughout. In contrast, the orthopaedic specialist nurse group had initial reservations about implementing the passport, but as the focus group unfolded, they moved from sharing individual views to finding commonalities and became more engaged and motivated to use the passport. ConclusionFocus groups are a practical and efficient tool to conduct within the usual working environment of an NHS hospital. In addition to capturing information about the challenges to implementation they may serve as a crucial implementation tool where evidence-based practice has not been adopted. ImpactThis is the first study carried out in the NHS setting highlighting the benefit of focus groups as a practical implementation tool. Contributions to literature· Diabetes is managed in the outpatient setting with care focusing on education and patient empowerment.· Barriers for implementation of empowerment tools have not been fully explored.· This study suggests the implementation of empowerment tools may pose an additional challenge to more specialist groups.· It demonstrates that focus groups are practical and efficient and may also have utility in the implementation process beyond identifying the barriers to embedding a new technology. · These findings contribute to the small body of evidence on the implementation of empowerment tools and highlight the benefit of focus groups as a useful tool in the implementation process.