Tailoring quality improvement interventions to identified barriers: a multiple case analysis

Bosch, Marina; Weijden, Trudy van der; Wensing, Michel; Grol, Richard

doi:10.1111/j.1365-2753.2006.00660.x

Cited by 210 publications

(215 citation statements)

References 35 publications

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“…It was important to identify potential barriers and facilitators in these settings, in order to tailor the implementation strategy. [28][29][30][31] An evidencebased implementation strategy according to Grol was used. 32 Second, a unique variance report ('Radboud variance report'; Appendix 1) had to be incorporated and developed together with the CP.…”

Section: Development Of the Cpmentioning

confidence: 99%

Implementation and Evaluation of a Clinical Pathway for Pancreaticoduodenectomy Procedures: a Prospective Cohort Study

Kolk

Boogaard

Becking-Verhaar

et al. 2017

Journal of Gastrointestinal Surgery

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Introduction Medical and nursing protocols in perioperative care for pancreaticoduodenectomy are mainly mono-disciplinary, limiting their integration and transparency in a continuous health care system. The aims of this study were to evaluate adherence to a multidisciplinary clinical pathway for all pancreaticoduodenectomy patients during their entire hospital stay and to determine if the use of this clinical pathway is associated with beneficial effects on clinical end points. Materials and Methods A prospective cohort study was conducted in 95 pancreaticoduodenectomy patients treated according to a clinical pathway, including a variance report, compared to a historical control group (n = 52) with a traditional treatment regime. Results Process evaluation of the clinical pathway group revealed that protocol adherence throughout all units was above 80%. Major complications according to Clavien-Dindo classification grade ≥3 decreased from 27 to 13%; p = 0.02. Hospital length of stay was significantly shorter in the clinical pathway group, median 10 days ], compared with the control group, median 13 days ; p = 0.02. Conclusion The use of a clinical pathway in pancreaticoduodenectomy patients was associated with high protocol adherence, improved outcome and shorter hospital length of stay. Variance report analysis and protocol adherence with a Prepare-ActReflect Cycle are essential in surveillance of outcome.

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Section: Development Of the Cpmentioning

confidence: 99%

Implementation and Evaluation of a Clinical Pathway for Pancreaticoduodenectomy Procedures: a Prospective Cohort Study

Kolk

Boogaard

Becking-Verhaar

et al. 2017

Journal of Gastrointestinal Surgery

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“…Recognition of the difficulties in changing health care processes has led to a new stream of "implementation" research to building knowledge for more successful change initiatives. Studies without a clear underpinning theory have contributed little to a generalisable implementation knowledge base (Bosch et al 2007;Checkland et al 2009;Proctor et al 2009;Ovretveit 2011 ) therefore researchers are now being asked to show a theoretical basis in change projects so that the theories are thereby tested and refined (The Improved Clinical Effectiveness through Behavioural Research Group 2006; Davies et al 2010). …”

Section: Practice Change and Implementation Sciencementioning

confidence: 99%

Changing practice to support self-management and recovery in mental illness: application of an implementation model

Harris

Jones²,

Heartfield

et al. 2015

Aust. J. Prim. Health

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Health services introducing practice changes need effective implementation methods. Within the setting of a community mental health service offering recovery-oriented psychosocial support for people with mental illness, we aimed to: (i) identify a well-founded implementation model; and (ii) assess its practical usefulness in introducing a new programme for recovery-oriented self-management support. We reviewed the literature to identify implementation models applicable to community mental health organisations, and that also had corresponding measurement tools. We used one of these models to inform organisational change strategies. The literature review showed few models with corresponding tools. The Promoting Action on Research Implementation in Health Services (PARIHS) model and the related Organisational Readiness to Change Assessment (ORCA) tool were used. The PARIHS proposes prerequisites for health service change and the ORCA measures the extent to which these prerequisites are present. Application of the ORCA at two time points during implementation of the new programme showed strategy-related gains for some prerequisites but not for others, reflecting observed implementation progress. Additional strategies to address target prerequisites could be drawn from the PARIHS model. The PARIHS model and ORCA tool have potential in designing and monitoring practice change strategies in community mental health organisations. Further practical use and testing of implementation models appears justified in overcoming barriers to change.

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“…Si bien algunas intervenciones son más efectivas que otras, se deben considerar múltiples elementos antes de decidir la estrategia de implementación más adecuada para un determinado contexto 33 . Es importante destacar, además, que numerosas publicaciones han resaltado el rol de las barreras y facilitadores tanto a nivel individual como organizacional para la implementación de las GPC [34][35][36][37][38] .…”

Section: Difusión Diseminación E Implementación De Gpcunclassified

Guías de práctica clínica: una introducción a su elaboración e implementación

Pantoja

Soto

2014

Rev. méd. Chile

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Tailoring quality improvement interventions to identified barriers: a multiple case analysis

Abstract: The design of quality improvement interventions appears to still be in its infancy. The translation of identified barriers into tailor-made implementation interventions is still a black box for both educational and organizational interventions.

Cited by 210 publications

References 35 publications

Implementation and Evaluation of a Clinical Pathway for Pancreaticoduodenectomy Procedures: a Prospective Cohort Study

Implementation and Evaluation of a Clinical Pathway for Pancreaticoduodenectomy Procedures: a Prospective Cohort Study

Changing practice to support self-management and recovery in mental illness: application of an implementation model

Guías de práctica clínica: una introducción a su elaboración e implementación

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