Anke J E de Veer1, Margot A H Fleuren2, Hille Voss3, Anneke L Francke4. 1. Netherlands Institute of Health Services Research (Nivel), Utrecht, The Netherlands. Electronic address: a.deveer@nivel.nl. 2. V&VN Dutch Nurses Association, Utrecht, The Netherlands. 3. Netherlands Institute of Health Services Research (Nivel), Utrecht, The Netherlands. 4. Netherlands Institute of Health Services Research (Nivel), Utrecht, The Netherlands; Amsterdam UMC, VU Amsterdam, Public Health Research Institute (APH), Amsterdam, The Netherlands; Expertise Center for Palliative Care Amsterdam, Amsterdam UMC, VU Medical Center Amsterdam, Amsterdam, The Netherlands.
Abstract
CONTEXT: Although much is known about factors influencing short-term implementation, little is known about what factors are relevant for the long-term sustainment of innovations. In the Dutch National Quality Improvement Program for Palliative Care, innovations were implemented in 76 implementation projects. OBJECTIVES: To give insight into the sustainment strategies used and factors facilitating and hindering sustainment. METHODS: Online questionnaire with prestructured and open questions sent to the contact persons for 76 implementation projects, 2-6.5 years after the start. RESULTS: Information was gathered on 63 implementation projects (response 83%). Most projects took place in home care, general practices, and/or nursing homes. Sustainment was attained in 60% of the implementation projects. Six often applied strategies were statistically significantly related to sustainment: 1) realizing coherence between the innovation and the strategic policy of the organization; 2) arranging to have a specific professional responsible for the use of the innovation; 3) integrating the innovation into the organization's broader palliative care policy; 4) arranging accessibility of the innovation; 5) involving management in the implementation project; and 6) giving regular feedback about the implementation. In three-quarters of the projects, barriers and facilitators were encountered relating to characteristics of the care organizations, such as employee turnover and ratification of the project by the management. CONCLUSION: Applying the six strategies enhances sustainment. The organization plays a decisive role in the sustainment of innovations in palliative care. Engaging the management team in implementation projects from early onset is of utmost importance.
CONTEXT: Although much is known about factors influencing short-term implementation, little is known about what factors are relevant for the long-term sustainment of innovations. In the Dutch National Quality Improvement Program for Palliative Care, innovations were implemented in 76 implementation projects. OBJECTIVES: To give insight into the sustainment strategies used and factors facilitating and hindering sustainment. METHODS: Online questionnaire with prestructured and open questions sent to the contact persons for 76 implementation projects, 2-6.5 years after the start. RESULTS: Information was gathered on 63 implementation projects (response 83%). Most projects took place in home care, general practices, and/or nursing homes. Sustainment was attained in 60% of the implementation projects. Six often applied strategies were statistically significantly related to sustainment: 1) realizing coherence between the innovation and the strategic policy of the organization; 2) arranging to have a specific professional responsible for the use of the innovation; 3) integrating the innovation into the organization's broader palliative care policy; 4) arranging accessibility of the innovation; 5) involving management in the implementation project; and 6) giving regular feedback about the implementation. In three-quarters of the projects, barriers and facilitators were encountered relating to characteristics of the care organizations, such as employee turnover and ratification of the project by the management. CONCLUSION: Applying the six strategies enhances sustainment. The organization plays a decisive role in the sustainment of innovations in palliative care. Engaging the management team in implementation projects from early onset is of utmost importance.
Authors: Stephanie M C Ament; Lisette M van den Broek; Marieke H J van den Beuken-van Everdingen; Josiane J J Boyne; José M C Maessen; Sebastiaan C A M Bekkers; Louise Bellersen; Hans-Peter Brunner-La Rocca; Yvonne Engels; Daisy J A Janssen Journal: BMC Palliat Care Date: 2022-01-04 Impact factor: 3.234
Authors: Dawn M Bravata; Edward J Miech; Laura J Myers; Anthony J Perkins; Ying Zhang; Nicholas A Rattray; Sean A Baird; Lauren S Penney; Curt Austin; Teresa M Damush Journal: BMC Health Serv Res Date: 2022-07-04 Impact factor: 2.908