Stephanie M C Ament1,2,3,4, Freek Gillissen1,2,4,5, Albine Moser1,3,6, José M C Maessen1,7,6, Carmen D Dirksen4, Maarten F von Meyenfeldt5, Trudy van der Weijden1,3. 1. CAPHRI, School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, the Netherlands. 2. GROW, School for Oncology & Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands. 3. Department of Family Medicine, CAPHRI, Maastricht University Medical Centre, Maastricht, the Netherlands. 4. Department of Clinical Epidemiology and Medical Technology Assessment, KEMTA, Maastricht University Medical Centre; CAPHRI, School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands. 5. Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands. 6. Faculty of Healthcare, Zuyd University of Applied Sciences, Heerlen, the Netherlands. 7. Department of Quality & Care, Maastricht University Medical Centre, Maastricht, the Netherlands.
Abstract
RATIONALE, AIMS, AND OBJECTIVES: Sustainability of innovations is a relatively new concept in health care research and has become an issue of growing interest. The current study explored factors related to the sustainability of 2 multidisciplinary hospital-based programs 3 to 6 years after achieving early implementation success. METHOD: An exploratory qualitative study was conducted into 2 implementation cases, an Enhanced Recovery After Surgery program for colorectal surgery and a short-stay program for breast cancer surgery. Semistructured interviews were held with key persons involved in the care process in 14 hospitals from both cases minimally 3 years after the implementation, between March 2012 and May 2013. The Consolidated Framework for Implementation Research was used to direct the development of the interview guide, during data collection and during analysis. A directed content analysis was performed. RESULTS: A total of 21 interviews with 26 individuals were held, 18 regarding the Enhanced Recovery After Surgery case and 8 regarding the short-stay program case. Respondents mentioned the following factors associated with sustainability of the programs: modification and adaptability of the program, cost-effectiveness, institutionalization into existing systems, short communication lines within the multidisciplinary team, an innovative culture, benefits for patients, cosmopolitanism, the existence of external policies and incentives, trust and belief in the program, and spread of the program to other settings. Two factors are not covered by the Consolidated Framework for Implementation Research, ie, modification of the program over the years and spread of the program to other contexts. CONCLUSIONS: The factors associated with sustainability put forward in both cases were largely the same. Leadership and the implementation project were not mentioned as having influenced the long-term sustainability of the benefits achieved. Sustainability of the innovations is influenced by determinants stemming from all ecological levels of the health care system and demands continuous effort in the postimplementation phase.
RATIONALE, AIMS, AND OBJECTIVES: Sustainability of innovations is a relatively new concept in health care research and has become an issue of growing interest. The current study explored factors related to the sustainability of 2 multidisciplinary hospital-based programs 3 to 6 years after achieving early implementation success. METHOD: An exploratory qualitative study was conducted into 2 implementation cases, an Enhanced Recovery After Surgery program for colorectal surgery and a short-stay program for breast cancer surgery. Semistructured interviews were held with key persons involved in the care process in 14 hospitals from both cases minimally 3 years after the implementation, between March 2012 and May 2013. The Consolidated Framework for Implementation Research was used to direct the development of the interview guide, during data collection and during analysis. A directed content analysis was performed. RESULTS: A total of 21 interviews with 26 individuals were held, 18 regarding the Enhanced Recovery After Surgery case and 8 regarding the short-stay program case. Respondents mentioned the following factors associated with sustainability of the programs: modification and adaptability of the program, cost-effectiveness, institutionalization into existing systems, short communication lines within the multidisciplinary team, an innovative culture, benefits for patients, cosmopolitanism, the existence of external policies and incentives, trust and belief in the program, and spread of the program to other settings. Two factors are not covered by the Consolidated Framework for Implementation Research, ie, modification of the program over the years and spread of the program to other contexts. CONCLUSIONS: The factors associated with sustainability put forward in both cases were largely the same. Leadership and the implementation project were not mentioned as having influenced the long-term sustainability of the benefits achieved. Sustainability of the innovations is influenced by determinants stemming from all ecological levels of the health care system and demands continuous effort in the postimplementation phase.
Authors: Julie Cowie; Avril Nicoll; Elena D Dimova; Pauline Campbell; Edward A Duncan Journal: BMC Health Serv Res Date: 2020-06-28 Impact factor: 2.655
Authors: Naomi E M Daniëls; Laura M J Hochstenbach; Marloes A van Bokhoven; Anna J H M Beurskens; Philippe A E G Delespaul Journal: Front Psychol Date: 2019-12-11