Keys to successful implementation of a French national quality indicator in health care organizations: a qualitative study

Waelli, Mathias; Gomez, Marie-Léandre; Sicotte, Claude; Zicari, Adrián; Bonnefond, Jean-Yves; Lorino, Philippe; Minvielle, Étienne

doi:10.1186/s12913-016-1794-7

Cited by 11 publications

(12 citation statements)

References 43 publications

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“…In order to put innovations into practice and achieve improved outcomes in new settings, the process of implementation is critical [2]. However, implementation is difficult, and the challenges involved in putting innovations into practice is a frequent topic of journals and conferences for researchers and practitioners [3–5]. …”

Section: Introductionmentioning

confidence: 99%

Value-based healthcare translated: a complementary view of implementation

Colldén

Hellström

2018

BMC Health Serv Res

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BackgroundInterest in the implementation of various innovations (e.g. medical interventions and organizational approaches) has increased rapidly, and management innovations (MIs) are considered particularly complex to implement. In contrast to a traditional view that innovations are implemented, some scholars have promoted the view that innovations are translated into contexts, a view referred to as translation theory. The aim of this paper is to investigate how a translation theory perspective can inform the Consolidated Framework of Implementation Research (CFIR) to increase understanding of the complex process of putting MIs into practice. The empirical base is a two-year implementation of the MI Value-Based Health Care (VBHC) to a psychiatric department in a large Swedish hospital.MethodsIn this longitudinal case study, a qualitative approach was applied using an insider researcher with unique access to data, who followed the implementation starting in 2015. Data sources includes field notes, documents, and audio recordings of meetings and group reflections which were abridged into an event data file structured by CFIR domains. In a joint analysis, an outsider researcher was added to strengthen the analysis and mitigate potential bias.ResultsTwo themes were identified, for which CFIR did not satisfactorily explain the findings. First, the intervention characteristics (i.e. the content of the MI) were modified along the process and, second, the process did not follow predefined plans. However, the project was still perceived to be successful by internal and external stakeholders.ConclusionsThe paper proposes three ways in which translation theory can inform CFIR when applied to MIs: 1) strength of evidence is not as important for MIs as for medical and technical innovations; 2) adaptability of the MI can be emphasized more strongly, and 3) it can be more fruitful to view implementation as a dynamic process rather than seeing it as a matter of planning and execution. For managers, this implies encouragement to seize the opportunity to translate MIs to fit their organization, rather than to aim to be true to an original concept.

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Section: Introductionmentioning

confidence: 99%

Value-based healthcare translated: a complementary view of implementation

Colldén

Hellström

2018

BMC Health Serv Res

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“…It helps to capture the emergence this contextually complex procedures during service processes (36), regarding to the healthcare system reality, which is known as work of "many hands" (43) This analytical model represents how the implementation of certi cation occurs at the level of hospital with the concerns the organisational logics of healthcare system, which is represent the care quality and patient safety. The integration capabilities of these quality tools depends on key attributes and elements of local contexts interacting via multiple mobilisation mechanisms, in other words, the socio-material local context (29). In terms of the contextual settings for certi cation implementation at nurse levels, knowledge, resources and material availability are fundamental (44,45).…”

Section: Discussionmentioning

confidence: 99%

“…However, it is essential to de ne these transversal components at the activity level, and understand how interventions could become embedded into activity systems, and their implication for healthcare quality (28). Therefore, several studies stressed the importance of local socio-material infrastructures and their effects on change integration (27), and how it was pivotal to generate quality improvement results (29). Therefore, in considering the dearth of professional frameworks on nurse activities in the literature, in this pilot study, we constructed a framework to analyse the implementation of quality policies, using the certi cation procedure as an example.…”

Section: Introductionmentioning

confidence: 99%

A Framework for the Implementation of Certification Procedures at Nurse Level: A Case Study in a French Hospital.

Salma

WAELLI

2020

Preprint

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Background: The implementation of certification procedures across healthcare systems is an essential component of the management process. In the past, several promising approaches have been developed towards the successful implementation of such policies, however, precise adaptation and implementation at the local context is essential. Thus, local activities must be considered to generate more pragmatic recommendations for managers. In this pilot study, we built an implementation framework for the inception of certification in healthcare facilities, particularly at nurse level activities. Our hypothesis comprised two objectives: the identification of key implementation process components, and the precise definition of these elements within local social activities.Methods: This study used a two-step abductive approach. The first was inductive, and consisted of a qualitative case study, where we analysed the implementation of certification procedures in a French teaching hospital. The study was conducted between April and December 2019. Data were collected using semi-structured interviews, and observations by shadowing. In the second step, the emerging data were analysed using two approaches: The Quality Implementation Tool (QIT) and Translational Mobilisation Theory (TMT). Results: Sixteen interviews were conducted with managers and nurses. We also accumulated 83 observational hours from two different wards. Our results showed that, first, all the retrieved elements over the implementation of certification procedures were captured by the QIT components and only one component was no applicable for the studied case. Second, we identified the elements in the local context of activity, with the different interrelationships between actors, actions and contexts, through the TMT. Third, our analyses were integrated and translated into a framework that described the implementation of certification procedures in healthcare facilities and with interest to the implementation at nurse/mid-managers level. In adopting QIT, the framework components took a transversal aspect then adapted to the local context of work through the TMT.Conclusions: In this study, we generated an implementation framework that underpinned a certification procedures implementation. Our approach revealed broad interactions between proximity managers, teams and contexts during change mobilisation, not captured by transversal framework only as QIT. Going forward, this framework must be tested in future empirical studies.

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“…This analytical model represents how the implementation of certi cation occurs at the level of hospital with the concerns the organisational logics of healthcare system, which is represent the care quality and patient safety. The integration capabilities of these quality tools depends on key attributes and elements of local contexts interacting via multiple mobilisation mechanisms, in other words, the socio-material local context (29). In terms of the contextual settings for certi cation implementation at nurse levels, knowledge, resources and material availability are fundamental (44,45).…”

Section: Discussionmentioning

confidence: 99%

A framework for the implementation of certification procedures at nurse level: a case study in a French hospital

Salma

Waelli

2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background The implementation of certification procedures across healthcare systems is an essential component of the management process. In the past, several promising approaches have been developed towards the successful implementation of such policies, however, precise adaptation and implementation at the local context is essential. Thus, local activities must be considered to generate more pragmatic recommendations for managers. In this pilot study, we built an implementation framework for the inception of certification in healthcare facilities, particularly at nurse level activities. Our hypothesis comprised two objectives: the identification of key implementation process components, and the precise definition of these elements within local social activities. Methods This study used a two-step abductive approach. The first was inductive, and consisted of a qualitative case study, where we analysed the implementation of certification procedures in a French teaching hospital. The study was conducted between April and December 2019. Data were collected using semi-structured interviews, and observations by shadowing. In the second step, the emerging data were analysed using two approaches: The Quality Implementation Tool (QIT) and Translational Mobilisation Theory (TMT). Results Sixteen interviews were conducted with managers and nurses. We also accumulated 83 observational hours from two different wards. Our results showed that, first, all the retrieved elements over the implementation of certification procedures were captured by the QIT components and only one component was no applicable for the studied case. Second, we identified the elements in the local context of activity, with the different interrelationships between actors, actions and contexts, through the TMT. Third, our analyses were integrated and translated into a framework that described the implementation of certification procedures in healthcare facilities and with interest to the implementation at nurse/mid-managers level. In adopting QIT, the framework components took a transversal aspect then adapted to the local context of work through the TMT. Conclusions In this study, we generated an implementation framework that underpinned a certification procedures implementation. Our approach revealed broad interactions between proximity managers, teams and contexts during change mobilisation, not captured by transversal framework only as QIT. Going forward, this framework must be tested in future empirical studies.

show abstract

Keys to successful implementation of a French national quality indicator in health care organizations: a qualitative study

Cited by 11 publications

References 43 publications

Value-based healthcare translated: a complementary view of implementation

Value-based healthcare translated: a complementary view of implementation

A Framework for the Implementation of Certification Procedures at Nurse Level: A Case Study in a French Hospital.

A framework for the implementation of certification procedures at nurse level: a case study in a French hospital

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