How to fall into a new routine: factors influencing the implementation of an admission and discharge programme in hospitals and general practices
Abstract Introduction The VESPEERA programme is a multifaceted programme to enhance information transfer between general practice and hospital across the process of hospital admission, stay and discharge. It was implemented in 7 hospitals and 72 general practices in Southern Germany. Uptake was hete...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-022-08644-5 |
| _version_ | 1811192476913893376 |
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| author | Johanna Forstner Nicola Litke Aline Weis Cornelia Straßner Joachim Szecsenyi Michel Wensing |
| author_facet | Johanna Forstner Nicola Litke Aline Weis Cornelia Straßner Joachim Szecsenyi Michel Wensing |
| author_sort | Johanna Forstner |
| collection | DOAJ |
| description | Abstract Introduction The VESPEERA programme is a multifaceted programme to enhance information transfer between general practice and hospital across the process of hospital admission, stay and discharge. It was implemented in 7 hospitals and 72 general practices in Southern Germany. Uptake was heterogeneous and overall low. A process evaluation aimed at identifying factors associated with the implementation of the VESPEERA programme. Methods This was a qualitative study using semi-structured interviews in a purposeful sample of health workers in hospitals and general practices in the VESPEERA programme. Qualitative framework analysis using the Consolidated Framework for Implementation Research was performed and revealed the topic of previous and new routines to be protruding. Inductive content analysis was used for in-depth examination of stages in the process of staying in a previous or falling into a new routines. Results Thirty-six interviews were conducted with 17 participants from general practices and 19 participants from hospitals. The interviewees were in different stages of the implementation process at the time of the interviews. Four stages were identified: Stage 1,’Previous routine and tension for change’, describes the situation in which VESPEERA was to be implemented and the factors leading to the decision to participate. In stage 2,’Adoption of the VESPEERA programme’, factors that influenced whether individuals decided to employ the innovation are relevant. Stage 3 comprises ‘Determinants for falling into and staying in the new VESPEERA-routine’ relates to actual implementation and finally, in stage 4, the participants reflect on the success of the implementation. Conclusions The individuals and organisations participating in the VESPEERA programme were in different stages of a process from the previous to the new routine, which were characterised by different determinants of implementation. In all stages, organisational factors were main determinants of implementation, but different factors emerged in different implementation stages. A low distinction between decision-making power and executive, as well as available resources, were beneficial for the implementation of the innovation. Trial registration DRKS00015183 on DRKS / Universal Trial Number (UTN): U1111-1218–0992. |
| first_indexed | 2024-04-11T23:53:13Z |
| format | Article |
| id | doaj.art-a8a7b17f6dd145e690211f4c26d00a63 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-11T23:53:13Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-a8a7b17f6dd145e690211f4c26d00a632022-12-22T03:56:26ZengBMCBMC Health Services Research1472-69632022-10-0122111210.1186/s12913-022-08644-5How to fall into a new routine: factors influencing the implementation of an admission and discharge programme in hospitals and general practicesJohanna Forstner0Nicola Litke1Aline Weis2Cornelia Straßner3Joachim Szecsenyi4Michel Wensing5Department of General Practice and Health Services Research, Heidelberg University HospitalDepartment of General Practice and Health Services Research, Heidelberg University HospitalDepartment of General Practice and Health Services Research, Heidelberg University HospitalDepartment of General Practice and Health Services Research, Heidelberg University HospitalDepartment of General Practice and Health Services Research, Heidelberg University HospitalDepartment of General Practice and Health Services Research, Heidelberg University HospitalAbstract Introduction The VESPEERA programme is a multifaceted programme to enhance information transfer between general practice and hospital across the process of hospital admission, stay and discharge. It was implemented in 7 hospitals and 72 general practices in Southern Germany. Uptake was heterogeneous and overall low. A process evaluation aimed at identifying factors associated with the implementation of the VESPEERA programme. Methods This was a qualitative study using semi-structured interviews in a purposeful sample of health workers in hospitals and general practices in the VESPEERA programme. Qualitative framework analysis using the Consolidated Framework for Implementation Research was performed and revealed the topic of previous and new routines to be protruding. Inductive content analysis was used for in-depth examination of stages in the process of staying in a previous or falling into a new routines. Results Thirty-six interviews were conducted with 17 participants from general practices and 19 participants from hospitals. The interviewees were in different stages of the implementation process at the time of the interviews. Four stages were identified: Stage 1,’Previous routine and tension for change’, describes the situation in which VESPEERA was to be implemented and the factors leading to the decision to participate. In stage 2,’Adoption of the VESPEERA programme’, factors that influenced whether individuals decided to employ the innovation are relevant. Stage 3 comprises ‘Determinants for falling into and staying in the new VESPEERA-routine’ relates to actual implementation and finally, in stage 4, the participants reflect on the success of the implementation. Conclusions The individuals and organisations participating in the VESPEERA programme were in different stages of a process from the previous to the new routine, which were characterised by different determinants of implementation. In all stages, organisational factors were main determinants of implementation, but different factors emerged in different implementation stages. A low distinction between decision-making power and executive, as well as available resources, were beneficial for the implementation of the innovation. Trial registration DRKS00015183 on DRKS / Universal Trial Number (UTN): U1111-1218–0992.https://doi.org/10.1186/s12913-022-08644-5ImplementationAdmission managementDischarge managementHospitalGeneral practiceRoutine |
| spellingShingle | Johanna Forstner Nicola Litke Aline Weis Cornelia Straßner Joachim Szecsenyi Michel Wensing How to fall into a new routine: factors influencing the implementation of an admission and discharge programme in hospitals and general practices BMC Health Services Research Implementation Admission management Discharge management Hospital General practice Routine |
| title | How to fall into a new routine: factors influencing the implementation of an admission and discharge programme in hospitals and general practices |
| title_full | How to fall into a new routine: factors influencing the implementation of an admission and discharge programme in hospitals and general practices |
| title_fullStr | How to fall into a new routine: factors influencing the implementation of an admission and discharge programme in hospitals and general practices |
| title_full_unstemmed | How to fall into a new routine: factors influencing the implementation of an admission and discharge programme in hospitals and general practices |
| title_short | How to fall into a new routine: factors influencing the implementation of an admission and discharge programme in hospitals and general practices |
| title_sort | how to fall into a new routine factors influencing the implementation of an admission and discharge programme in hospitals and general practices |
| topic | Implementation Admission management Discharge management Hospital General practice Routine |
| url | https://doi.org/10.1186/s12913-022-08644-5 |
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