Improving patient care : the implementation of change in health care

著者

書誌事項

Improving patient care : the implementation of change in health care

edited by Michel Wensing, Richard Grol, Jeremy Grimshaw

John Wiley & Sons, 2020

3rd ed.

  • hbk

大学図書館所蔵 件 / 全1件

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注記

Includes bibliographical references and index

収録内容

  • Implementation of change in healthcare : a complex problem / Richard Grol, Michel Wensing
  • Theories on implementation of change in healthcare / Michel Wensing, Richard Grol
  • Effective implementation of change in healthcare : a systematic approach / Richard Grol, Michel Wensing
  • Planning and organizing the change process / Richard Grol, Michel Wensing
  • Characteristics of successful innovations / Richard Grol, Michel Wensing
  • Clinical practice guidelines as a tool for improving patient care / Jako Burgers, Trudy van der Weijden, Richard Grol
  • Indicators for quality and safety of care / Jozé Braspenning, Rosella Hermens, Hilly Calsbeek, Stephen Campbell, Philip van der Wees, Richard Grol
  • Determinants of implementation / Michel Wensing, Richard Grol
  • Methods to identify and analyze determinants of implementation / Michel Wensing, Richard Grol
  • Selection of strategies for improving patient care / Richard Grol, Michel Wensing
  • Dissemination of innovations / Richard Grol, Michel Wensing
  • Educational implementation strategies / Michel Wensing, Cornelia Fluit, Jeremy Grimshaw, Richard Grol
  • Clinical performance feedback and decision support / Noah Ivers, Benjamin Brown, Jeremy Grimshaw
  • Engaging patients in healthcare improvement and innovation / Glyn Elwyn, Amy Price
  • Organizational implementation strategies / Michel Wensing, Miranda Laurant, Richard Grol
  • Patient safety strategies / Marieke Zegers, Mirelle Hanskamp-Sebregts, Hub Wollersheim, Charles Vincent
  • Health system strategies for implementation / Michel Wensing, Holger Pfaff, Richard Grol
  • Multifaceted implementation strategies / Marlies Hulscher, Michel Wensing
  • Planning of implementation / Richard Grol
  • Experimental designs for evaluation of implementation strategies / Michel Wensing, Jeremy Grimshaw
  • Observational evaluation of implementation strategies / Michel Wensing, Jeremy Grimshaw
  • Process evaluation of implementation strategies / Marlies Hulscher, Michel Wensing
  • Economic evaluation of implementation strategies / Johan L. Severens, Ties Hoomans, Eddy Adang, Michel Wensing

内容説明・目次

内容説明

Strategies for successfully updating and improving health care organizations of all kinds Health care is always evolving and improving. However, the rapid speed of medical advancement can make the adoption of new technologies and practices a challenging process - particularly in large organizations and complex networks. Any projected impact upon quality and outcomes of care must be carefully evaluated so that changes may be implemented in the most efficacious and efficient manner possible. Improving Patient Care equips professionals and policymakers with the knowledge required to successfully optimize health care practice. By integrating scientific evidence and practical experience, the text presents a cohesive and proven model for practice change and innovation, complete with analysis of innovation, target group and setting; selection and application of strategies; and evaluation of process, outcomes and costs. This new third edition also includes: Newly written chapters on clinical performance feedback, patient engagement, patient safety, evaluation designs, and methods for process evaluation Increased emphasis on the role of contextual influences in implementation and improvement New research examples from across the world and updated scientific literature throughout Designed to help promote safer and more efficient, patient-centered care and better outcomes, Improving Patient Care is an essential resource for healthcare providers, quality assessors, and students of health services research, health management, and health policy.

目次

List of Contributors xv Introduction xix Part I Principles of the Implementation of Change 1 1 Implementation of Change in Healthcare: A Complex Problem 3 Richard Grol and Michel Wensing 1.1 Introduction 3 1.2 The Implementation Problem 5 1.2.1 Effective Care 6 1.2.2 Safe Care 6 1.2.3 Efficient Care 7 1.2.4 Access to Care 8 1.2.5 Patient-Centered Care 8 1.2.6 Variation in the Provision of Care 8 1.3 Various Approaches to the Implementation of Change in Patient Care 9 1.4 What is Implementation? 12 1.5 Which Recommended Practices Should Be Adopted? 15 1.5.1 New Insights and Technologies 15 1.5.2 Problems in Healthcare Practice 16 1.6 A Systematic Approach to "Sustainable Change" 16 References 17 2 Theories on Implementation of Change in Healthcare 21 Michel Wensing and Richard Grol 2.1 Introduction 21 2.2 Theories on Factors Related to Individual Professionals 23 2.2.1 Cognitive Theories 23 2.2.2 Educational Theories 25 2.2.3 Motivational Theories 26 2.3 Theories on Social Processes 27 2.3.1 Social Learning Theory 27 2.3.2 Theories on Communication 27 2.3.3 Social Network Theories 28 2.3.4 Theories on Teamwork 29 2.3.5 Theories on Professionalization 29 2.3.6 Theories on Leadership 30 2.4 Theories on Organizational Systems 31 2.4.1 Theories of Effective Organizations 31 2.4.2 Theory of Quality and Safety Management 31 2.4.3 Theory of Operations Management 33 2.4.4 Theory of Complex Systems 33 2.4.5 Theory of Organizational Learning 34 2.4.6 Theories of Organizational Culture 35 2.5 Theories on Economic and Societal Structures 36 2.5.1 Economic Theories 36 2.5.2 Theories on Contracting 37 2.6 Conclusions 37 References 39 3 Effective Implementation of Change in Healthcare: A Systematic Approach 45 Richard Grol and Michel Wensing 3.1 Elements of Effective Implementation 45 3.2 The Implementation of Change Model 52 3.3 Developing a Proposal and Targets for Change 53 3.4 Assessment of Performance 55 3.5 Analysis of the Target Group and Setting 56 3.5.1 Aims and Settings of the Implementation 57 3.5.2 Segments within the Target Group and Stages of Change 57 3.5.3 Phases in a Process of Change: A Summary of the Literature 58 3.5.4 Orientation 59 3.5.5 Insight 59 3.5.6 Acceptance 59 3.5.7 Change 60 3.5.8 Maintenance 60 3.5.9 Barriers and Facilitators to Changing Practice 60 3.6 Selection and Development of Improvement Strategies 61 3.7 Development, Testing, and Execution of an Implementation Plan 61 3.8 Sustainable Change: Integration of Change into Practice Routines 63 3.9 Evaluation and (Possible) Adaptations to the Plan 63 3.10 Planning of the Implementation Process 66 3.11 Conclusions 68 References 68 4 Planning and Organizing the Change Process 73 Richard Grol and Michel Wensing 4.1 Introduction 73 4.2 A Motivated Team Comprising All Relevant Expertise 75 4.3 Creating a Context for Change 76 4.3.1 The Central Role of Physicians 76 4.3.2 Collaboration in Teams for Patient Care 78 4.4 Involving the Target Group and Stakeholders in the Plan 81 4.5 Leaders and Key Figures 81 4.5.1 Medical Leadership 82 4.6 Project Management: Time Schedule and Responsibilities 82 4.7 Resources and Support 83 4.8 Conclusions 84 References 84 Part II Guidelines and Innovations 87 5 Characteristics of Successful Innovations 89 Richard Grol and Michel Wensing 5.1 Introduction 89 5.2 Various Types of Improvements Require Various Types of Change Proposals 91 5.2.1 Scientific Literature, Guidelines, Decision Support, and Decision Aids 91 5.2.2 Clinical Pathways 92 5.2.3 Improved Care Processes 93 5.2.4 Other Innovations 93 5.3 Characteristics of Innovations That Promote Implementation 94 5.4 Format and Presentation 97 5.5 Involvement of the Target Group and Local Adaptation 99 5.6 Conclusions 100 References 100 6 Clinical Practice Guidelines as a Tool for Improving Patient Care 103 Jako Burgers, Trudy van der Weijden, and Richard Grol 6.1 Introduction 103 6.2 Aims of Guidelines 104 6.3 Potential Benefits and Limitations of Guidelines 105 6.3.1 Potential Benefits 106 6.3.2 Possible Limitations 106 6.4 Development of Effective Guidelines 107 6.4.1 Topic Selection 107 6.4.2 Composition of the Guideline Development Group 110 6.4.3 Patient and Public Involvement 111 6.4.4 Drafting the Scope 113 6.4.5 Development of Draft Guideline 114 6.4.6 Identifying and Reviewing Available Guidelines and Reviews 114 6.4.7 Collection and Evaluation of Scientific Evidence 115 6.4.8 Contribution of All Relevant Expertise and Experience 116 6.4.9 Formulation of Recommendations 116 6.4.10 Consultation and Authorization 118 6.4.11 Consultation 118 6.4.12 Pilot Testing 119 6.4.13 Authorization 119 6.4.14 Design of the Guideline and Related Products 119 6.4.15 Evaluation 120 6.4.16 Updating Guidelines 121 6.5 Quality of Guidelines and Guideline Development Programs 121 6.6 International Collaboration in Guideline Development 123 6.7 Conclusion 124 References 125 Part III Assessment of Performance 131 7 Indicators for Quality and Safety of Care 133 Joze Braspenning, Rosella Hermens, Hilly Calsbeek, Stephen Campbell, Philip van der Wees, and Richard Grol 7.1 Introduction 133 7.1.1 Aim of the Assessment 135 7.2 Indicators for Quality and Safety of Care 137 7.2.1 Aims of Measurement 137 7.2.2 Domains and Perspectives 138 7.2.3 Categories of Indicators 138 7.3 Methods to Develop a Set of Indicators 140 7.4 Selecting or Developing a Preliminary Set of Indicators 140 7.4.1 Indicator Attributes 141 7.4.2 Number of Indicators 141 7.5 Finding Consensus among Target Users 141 7.5.1 Delphi Technique 142 7.5.2 RAND/UCLA Appropriateness Method 142 7.6 Testing the Indicators Empirically 144 7.6.1 Validity and Reliability 144 7.7 Create a Feedback Report 147 7.7.1 Calculating Indicators and Benchmarks 147 7.7.2 Formulating Aims of Improvement 147 7.8 Use and Effect of Quality Indicators 148 7.8.1 Unintended Effects 148 7.9 Conclusion 149 References 150 Part IV Problem Analysis 155 8 Determinants of Implementation 157 Michel Wensing and Richard Grol 8.1 Introduction 157 8.2 Analysis of Stakeholders 159 8.3 Determinants of Change 161 8.3.1 Individual Health Professional Factors 161 8.3.1.1 Cognitive Factors 161 8.3.1.2 Motivational Factors 162 8.3.1.3 Behavioral Factors (Routines) 163 8.3.2 Patient Factors 163 8.3.3 Professional Interactions 163 8.3.3.1 Team Processes 163 8.3.4 Professional Networks 164 8.3.5 Organizational Factors 165 8.3.5.1 Capacity for Organizational Change 165 8.3.6 Organizational Structure 165 8.3.7 Organizational Culture 166 8.3.8 Availability of Necessary Resources 166 8.3.9 Societal Factors 166 8.3.9.1 Health Professions 166 8.3.9.2 Financial Incentives and Disincentives 167 8.3.9.3 Legislation 167 8.4 Subgroups in the Target Population 167 8.5 Conclusions 168 References 168 9 Methods to Identify and Analyze Determinants of Implementation 173 Michel Wensing and Richard Grol 9.1 Introduction 173 9.2 Interviews 175 9.2.1 Individual Interviews 175 9.2.2 Group Interviews 175 9.3 Surveys 177 9.3.1 Questionnaires about Clinical Guidelines 178 9.3.2 Questionnaires on Theory-Based Determinants of Implementation 178 9.4 Observation 180 9.4.1 Routinely Collected Data 180 9.4.2 Direct Observation 180 9.5 Data Analysis 181 9.5.1 Scientific Methods of Data Analysis 182 9.5.2 Quality Improvement Methods 183 9.5.3 Paretogram 183 9.5.4 Fishbone Diagram 184 9.5.5 Flow Chart 185 9.6 Prioritization and Goal Setting 186 9.7 Conclusions 186 References 187 Part V Strategies for Change 189 10 Selection of Strategies for Improving Patient Care 191 Richard Grol and Michel Wensing 10.1 Introduction 191 10.2 Methods to Select and Develop Implementation Strategies 192 10.2.1 Explorative Methods 194 10.2.2 Theory-Based Methods 196 10.3 Classification of Implementation Strategies 196 10.4 Implementation Strategies in the Different Phases of Change 199 10.4.1 Orientation 200 10.4.2 Insight and Understanding 200 10.4.3 Acceptance 201 10.4.4 Change 201 10.4.5 Maintenance 202 10.5 Subgroups within the Target Group 202 10.6 The Effectiveness of Different Strategies and Interventions 203 10.7 Conclusions 204 References 205 11 Dissemination of Innovations 207 Richard Grol and Michel Wensing 11.1 Introduction 207 11.2 Mass Media Approach 210 11.2.1 Written Materials 210 11.2.2 Internet-Based Approaches 210 11.2.3 Factors Associated with the Impact of Mass Media Strategies 212 11.3 Personalized Approaches 213 11.3.1 CME Courses and Conferences 214 11.3.2 Social Networks 214 11.3.3 Influential Individuals 215 11.3.4 Personal Introduction in Practice 216 11.4 Conclusion 217 References 218 12 Educational Implementation Strategies 221 Michel Wensing, Cornelia Fluit, Jeremy Grimshaw, and Richard Grol 12.1 Introduction 221 12.2 Types of Educational Strategies 223 12.3 Effectiveness of Education 224 12.3.1 Educational Materials 225 12.3.2 Educational Meetings 225 12.3.3 Outreach Visits 226 12.3.4 E-learning 226 12.4 Determinants of the Effectiveness of Education 227 12.4.1 Targets for Education 228 12.4.2 Active Participation 229 12.4.3 Duration of Education 229 12.4.4 Opinion Leaders 229 12.4.5 Assessment and Feedback 230 12.5 Discussion and Conclusions 230 References 231 13 Clinical Performance Feedback and Decision Support 235 Noah Ivers, Benjamin Brown, and Jeremy Grimshaw 13.1 Introduction 235 13.2 Definitions, Characteristics, and Components 238 13.2.1 Feedback 238 13.2.2 Decision Support 238 13.3 Effectiveness of Feedback and Decision Support 239 13.4 Factors Associated with Effects 241 13.4.1 Underlying Assumptions, Relevant Theories, and Mechanisms 241 13.4.2 Factors Associated with Effects 242 13.5 Discussion and Conclusions 246 References 248 14 Engaging Patients in Healthcare Improvement and Innovation 253 Glyn Elwyn and Amy Price 14.1 Introduction 253 14.2 Impact of Patient Engagement on Direct Care 254 14.2.1 Well-Established Conceptual Frameworks 254 14.2.2 Persistent Theory-Practice Gap 255 14.2.3 Broader Impacts 256 14.3 Impact of Patient Engagement on Organizational Design and Governance 257 14.4 Impact of Patient Engagement in Policy Making 259 14.5 Conclusion 260 References 260 15 Organizational Implementation Strategies 263 Michel Wensing, Miranda Laurant, and Richard Grol 15.1 Introduction 263 15.2 Revision of Professional Roles 264 15.3 Enhanced Patient Care Teams 266 15.4 Knowledge Management (Use of IT) 267 15.5 Integrated Care Systems 269 15.6 Quality and Safety Management 271 15.7 Conclusions 272 References 272 16 Patient Safety Strategies 275 Marieke Zegers, Mirelle Hanskamp-Sebregts, Hub Wollersheim, and Charles Vincent 16.1 Introduction 275 16.2 Definition of Patient Safety Concepts 276 16.3 Strategies to Measure Patient Safety 277 16.4 Patient Safety Improvement Strategies 280 16.4.1 Teamwork Training 280 16.4.2 Improved Handovers 280 16.4.3 Rapid Response Team 285 16.4.4 Infection Prevention 285 16.4.5 Delirium Prevention 286 16.4.6 Fall Prevention 287 16.4.7 Pressure Ulcers 287 16.4.8 Pain Management 287 16.4.9 Interventions to Prevent Adverse Drug Events 288 16.5 Strategies to Assure Patient Safety 289 16.5.1 Leadership 289 16.5.2 Safety Culture 290 16.5.3 Governance 290 16.6 Conclusions 292 References 292 17 Health System Strategies for Implementation 299 Michel Wensing, Holger Pfaff, and Richard Grol 17.1 Introduction 299 17.2 Strategies to Enhance Evidence-Based Policy Making 300 17.3 Scaling Up Interventions and Practices 303 17.4 Changes in the Financial Reimbursement of Healthcare Providers 304 17.5 Changes in the Financial Risk for Patients 306 17.6 Changes in the Healthcare System 307 17.7 Conclusions 309 References 309 18 Multifaceted Implementation Strategies 313 Marlies Hulscher and Michel Wensing 18.1 Introduction 313 18.2 Strategies in Multifaceted Implementation Strategies 314 18.3 Effectiveness of Multifaceted Implementation Strategies 320 18.4 Tailoring in Multifaceted Strategies 320 18.5 Volume and Classification of Strategies 321 18.6 Combinations of Specific Strategies 322 18.7 Conclusions 324 References 325 Part VI Organization and Evaluation 329 19 Planning of Implementation 331 Richard Grol 19.1 Introduction 331 19.1.1 Planning of the Implementation Process 334 19.2 Development of the Plan According to Phases in the Change Process 334 19.3 Planning of Activities for Different Levels of Care 336 19.4 Planning of Activities over Time 337 19.5 Incorporating the Implementation Plan into Existing Activities 337 19.6 Testing of the Implementation Strategies 338 19.7 Setting Goals for Evaluation 339 19.8 Integration and Embedding of New Practice into Routines and Organization 340 19.9 Conclusions 342 References 343 20 Experimental Designs for Evaluation of Implementation Strategies 345 Michel Wensing and Jeremy Grimshaw 20.1 Introduction 345 20.2 Experimental Study Designs 347 20.2.1 Pragmatic versus Explanatory Trials 348 20.2.2 Cluster Randomization 348 20.2.3 Options for Choice of Study Groups 349 20.2.4 Block Designs 349 20.2.5 Allocation of Participants to Study Arms 350 20.3 Outcome Measures and Data-Collection Methods 351 20.4 Statistical Power and Data Analysis 353 20.5 Regulatory and Ethical Considerations 354 20.6 Conclusion 354 References 355 21 Observational Evaluation of Implementation Strategies 357 Michel Wensing and Jeremy Grimshaw 21.1 Introduction 357 21.2 Designs for Observational Evaluations 358 21.3 Cross-Sectional Studies 359 21.4 Before-After Comparisons 359 21.5 Controlled Before-After Comparisons 361 21.6 Multiple Case Studies 363 21.7 Developmental Research 364 21.8 Data Analysis in Observational Evaluation Designs 365 21.9 Conclusions 366 References 366 22 Process Evaluation of Implementation Strategies 369 Marlies Hulscher and Michel Wensing 22.1 Introduction 369 22.2 Frameworks for Process Evaluation 370 22.3 Process Evaluation and Implementation Strategies 372 22.3.1 Evaluation of Pilots and Small Improvement Projects 373 22.3.2 Evaluation of Strategies in Experimental Designs 373 22.3.3 Evaluation of Improvement Programs in Observational Designs 374 22.4 Assessing the Fidelity of Implementation Strategies 374 22.5 Framing Process Evaluations 378 22.6 A Practical, Step-wise Approach to Process Evaluation 381 22.6.1 Step 1: Analysis of Implementation Strategy as Planned 381 22.6.2 Step 2: Assessment of Intervention Fidelity 382 22.6.3 Step 3: Assessment of Participant Experiences 383 22.6.4 Step 4: Exploration of Working Mechanisms 384 22.7 Conclusions 385 References 386 23 Economic Evaluation of Implementation Strategies 389 Johan L. Severens, Ties Hoomans, Eddy Adang, and Michel Wensing 23.1 Introduction 389 23.2 The Basics of Economic Evaluation 390 23.2.1 Definition of Cost-Effectiveness 391 23.3 Types of Economic Evaluation 392 23.4 Policy Cost-Effectiveness 395 23.5 Framing Economic Evaluations 396 23.5.1 Choice of Comparator 396 23.5.2 Time Horizon of a Study 396 23.5.3 Study Perspective 396 23.6 Cost Analysis 398 23.6.1 Directly Attributable, Indirectly Attributable, Fixed, and Variable Costs 398 23.6.2 Categories of Costs 399 23.6.3 Volumes and Cost Prices 400 23.7 Sensitivity Analysis, Quantitative Modeling, and Budget Impact 402 23.7.1 Sensitivity Analysis 402 23.7.2 Quantitative Modeling 403 23.7.3 Budget Impact Analysis 404 23.8 Ex Post Evaluation of the Efficiency of Implementation 405 23.9 Conclusions 405 References 406 Index 409

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