Background
Theoretical background
Consolidated framework for implementation research
Translation of management innovations
Value-based health care
Method
Setting
Data collection
Study object | Group members | Role in practice | Rationale for study |
---|---|---|---|
Project group | Two cooperating project leaders, one care developer, and administrative support | Led the local implementation project, developed material as decision basis, planned and coordinated pilot projects, and led meetings with the steering and reference groups and other stakeholders. | The core of the implementation process, where most of the actual work was done, and information and actual power was concentrated. |
Steering group | Seven members including the head of department, four first-line managers, one operations coordinator at department level, and one quality controller at division level. | Made all strategic decisions, based on the material produced by the projects group and discussions together with the reference group. | Constituted a managerial perspective from within the context and had important power over strategic decisions. |
Reference group | Twelve employees with different professions and from different units within the department, chosen to include as many perspectives as possible. | Gave feedback on decision basis material and discussed questions raised by the project group to help the project and steering groups to make strategic decisions. | Provided important information about the inner context and affected both the content and the process of implementation. |
Internal consultants | This hospital-level unit consisted of 6–10 consultants specialized in e.g. logistics, implementation, and quality assurance, trained in VBHC. Two consultants were involved in the project group for schizophrenia. | Controlled the implementation of VBHC initiative at hospital level, provided implementation support to project groups in different departments, and arranged joint meetings for all active project groups. | Important stakeholder, controlling the framework for implementation, hence constituting an important part of the outer context and also provided an outsider perspective assessing the level of success of the local implementation project. |
Forum | Type of documentation | n |
---|---|---|
Project group meetings | Field notes | 35 |
Audio recordings (full) | 4 | |
Joint meetings with steering and reference groups | Field notes | 9 |
Audio recordings (full) | 2 | |
Other related meetings and events | Field notes | 18 |
Guidelines, documentation, mailings, etc. from and in between meetings and events | Documents | 53 |
Reflective discussions with project group | Audio recordings | 13 |
Data analysis
Domain | Construct | Description |
---|---|---|
Intervention Characteristics | Intervention source | Key stakeholders’ perceptions of whether the intervention developed within or outside of the organization. |
Evidence strength & quality | The perception of stakeholders regarding the validity of evidence in support of the intervention’s potential to bring about the desired outcomes. | |
Relative advantage | Advantage of the intervention over alternative solutions in the eyes of stakeholders. | |
Adaptability | The degree to which the intervention can be transformed or customized to fit with local needs. | |
Trialability | The potential for testing the intervention in small, reversible steps. | |
Complexity | Perceived intricacy of the implementation due to scope, disruptiveness, profoundness, number of stakeholder groups, etc. | |
Design quality and packaging | Perception regarding how well compiled and presented the intervention is. | |
Cost | Costs associated with the implementation and use of the intervention. | |
Process | Planning | The quality of a pre-defined method or scheme for the implementation, and the degree to which it is applied. |
Engaging | Attracting and involving key individuals (listed below) in strategies including social marketing, training, role modelling, etc. | |
- Opinion leaders | Organization members with formal or informal influence on colleagues. | |
- Implementation leaders | Individuals in the organization who have been formally appointed as responsible for the implementation. | |
- Champions | Dedicated individuals who are passionate about the intervention. | |
- External change agents | Individuals who are not part of the organization but formally affect or facilitate implementation positively. | |
Executing | Accomplishing the implementation according to the plans made in advance. | |
Reflecting & evaluating | Feedback about the implementation progress, for example through regular personal and team reflections on progress and experiences. |