Background
Methods
Intervention
Implementation
Research area
Data collection
Data analysis
Ethical considerations
Results
Acute care chain | Participants | Non response |
---|---|---|
CVA | 7 | |
Myocardial infarction | - | Split in care chain coordination, FG interview not feasible |
Acute obstetrics | - | No existing FG |
Acute hip traumas | 11 | |
Acute psychiatrics | 14 | |
Acute abdominal complaints | 4 | |
Implementation group | 3 |
Acute care chain | Questionnaires send | Questionnaires returned | % |
---|---|---|---|
CVA | 7 | 3 | 42.8 |
Myocardial infarction | 7 | 5 | 71.4 |
Acute Obstetrics | 8 | 5 | 62.5 |
Acute hip traumas | 6 | 3 | 50.0 |
Acute psychiatrics | 5 | 4 | 80.0 |
Acute abdominal complaints | 7 | 3 | 42.9 |
Total | 40 | 23 | 57.5 |
Routines
Organizational aspects
Feature | N | Influence on implementation (%) | ||||||
---|---|---|---|---|---|---|---|---|
Very positive | Fairly positive | Not positive/not negative | Fairly negative | Very negative | Unknown | |||
Routines
|
The existing ways of information transfer in the care chain
| 23 | 0.0 | 13.0 | 30.5 | 21.7 | 0.0 | 34.8 |
The existing ways of feedback in the care chain
| 23 | 0.0 | 13.0 | 17.4 | 26.1 | 4.3 | 39.2 | |
Organization
|
The existing division of tasks between care providers in this care chain
| 23 | 0.0 | 26.1 | 26.1 | 8.7 | 0.0 | 39.1 |
The current division of responsibilities and authority between care providers in this care chain
| 23 | 0.0 | 8.7 | 34.8 | 13.0 | 0.0 | 43.5 | |
The current division of responsibilities and authority between organizations in this care chain
| 23 | 0.0 | 8.7 | 30.4 | 13.0 | 0.0 | 47.9 | |
The inadequate cooperation between care providers in this care chain
| 23 | 0.0 | 8.7 | 13.0 | 26.1 | 0.0 | 52.2 | |
The nonexistence of a protocol for information transfer on care chain level
| 23 | 0.0 | 4.3 | 17.4 | 26.1 | 0.0 | 52.2 | |
The guiding of information transfer by managers in this care chain
| 23 | 0.0 | 4.3 | 30.4 | 13.0 | 0.0 | 52.3 | |
The guiding of feedback by managers in this care chain
| 23 | 0.0 | 4.3 | 34.8 | 8.7 | 0.0 | 52.2 | |
The cooperation with multiple disciplines in the acute care chain
| 23 | 8.7 | 39.1 | 13.0 | 8.7 | 0.0 | 30.5 | |
The cooperation with multiple organizations in the acute care chain
| 23 | 0.0 | 34.8 | 21.7 | 13.0 | 0.0 | 30.5 | |
Feature
|
N
| (%)
| ||||||
Very urgent | Fairly urgent | Neutral | Fairly unimportant | Very unimportant | Don’t know | |||
Sense of urgency
|
How urgent do you experience the need for improvements in information transfer?
| 23 | 8.7 | 30.4 | 21.7 | 8.7 | 0.0 | 30.5 |
How urgent do you experience the need for improvements in feedback?
| 23 | 4.3 | 39.1 | 21.7 | 4.3 | 0.0 | 30.6 |
Sense of urgency
Implementation methods
Acute care chain | Barrier | Facilitator |
---|---|---|
Implementation care chain (acute abdominal complaints) |
Routines
|
Routines
|
- Work routines differ between organizations involved in the care chain | ||
- Feedback is not provided formally yet | ||
- Providing feedback is not a work routine | ||
- A non-electronic form differs from current routines, as electronic systems are used | ||
- Procedures of information transfer and feedback are absent | ||
Organization
|
Organization
| |
- There is no coordination of the acute care chain | - The redesign should fit into the organization’s policy | |
Sense of urgency
|
Sense of urgency
| |
- In practice, the sense of urgency might have been very low | - On a higher organizational level, there was a sense of urgency for improvement | |
Implementation methods
| ||
- Top down implementation approach | ||
- Implementation during holiday season | ||
- Features of the redesign itself | ||
Other factors
|
Other factors
| |
- Practical experience shows that care providers were not willing to work according to the redesign | - The redesign is desirable | |
Control care chains* (acute hip traumas, acute psychiatric care, CVA) |
Routines
|
Routines
|
- Work routines differ between districts and organizations involved in the care chain | ||
- The redesign differs from the current work routines | ||
- Organizations are used to work with digital systems instead of paperwork. | ||
Organization
|
Organization
| |
- There is no coordination of the acute care chain | - The redesign should fit into the organization’s policy | |
Sense of urgency
|
Sense of urgency
| |
- A need for improvement in information transfer and feedback is experienced, although may not be very urgent | ||
Implementation methods
| ||
- Top down implementation approach | ||
- Implementation during holiday season | ||
- Features of the redesign itself | ||
Other factors
|
Other factors
| |
- Willingness to work with the redesign depends on whether it is digital or not. As a paper version, willingness would not be very high | - The ideas behind the redesign are probably desirable |