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Perceived enabling factors and barriers for the implementation of improvements in health care in order to achieve patient-centred care: A case report from Sweden
University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational Health Science and Psychology, Occupational Health Science. University of Gävle, Centre for Musculoskeletal Research. Centre for Research and Development, Region Gävleborg/Uppsala University, Gävle, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.ORCID iD: 0000-0001-6067-3520
Centre for Research and Development, Region Gävleborg/Uppsala University, Gävle, Sweden.
University of Gävle, Faculty of Health and Occupational Studies, Department of Caring Science, Caring Science. Centre for Research and Development, Region Gävleborg/Uppsala University, Gävle, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
2019 (English)In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753Article in journal (Refereed) Epub ahead of print
Abstract [en]

Abstract Rationale, aim, and objectives More knowledge is needed regarding the complex factors and perceptions that enable the implementation of change in health care. The study aimed to examine the enabling factors and barriers encountered in the implementation of improvements in health care in order to achieve patient-centred care (PCC) and to study if there was a correlation in the extent the improvements were perceived to be implemented and the preconditions that were considered to affect them. Methods Using a mixed method design, data were gathered via a questionnaire and individual interviews with health care personnel, clinic managers, and first-line managers. The data collection and analyses were based on the framework for Promoting Action on Research Implementation in Health Services (PARiHS). Correlations between PCC improvements and preconditions for improvements were performed. Results A high level of involvement, knowledge, and adequate resources were considered important to achieve an implementation of PCC with joint responsibility. Leadership and management need to be explicit and promote continuous follow-up and feedback. Preconditions for improvement had a linear correlation with the perceived level of implementation. Knowledge-related preconditions had greatest impact on implementation. Conclusions The PARiHS framework was appropriate to use since the three components of evidence, context, and facilitation present different important preconditions in the implementation process. Evidence was the highest rated contributor since evidence-based practices in health care are necessary. It is vital that the important role of the context and facilitators is acknowledged in the implementation process to enable a successful implementation of change. There is a need to incorporate a clear strategy involving all levels in the organization. Furthermore, leaders play an important role in the implementation by facilitating communication and support and by having trust in facilitators and health care personnel. The results are applicable to other interventions implementing change in health care.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019.
Keywords [en]
health care, implementation, improvements, PARiHS, patient-centred care
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:hig:diva-30629DOI: 10.1111/jep.13272PubMedID: 31475435Scopus ID: 2-s2.0-85071485440OAI: oai:DiVA.org:hig-30629DiVA, id: diva2:1348703
Conference
2019/09/05
Note

Funding: Region Gävleborg

Available from: 2019-09-05 Created: 2019-09-05 Last updated: 2019-10-04Bibliographically approved

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Wijk, KatarinaLindberg, Maria

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