Improving patient care [electronic resource] : the implementation of change in health care /
edited by Richard Grol ... [et al.].
2nd ed.
Chichester, UK ; Hoboken, NJ, USA : Wiley Blackwell, BMJ/Books, 2013.
xvii, 374 p. : ill. ; 25 cm.
9780470673386 (pbk.)
More Details
added author
Chichester, UK ; Hoboken, NJ, USA : Wiley Blackwell, BMJ/Books, 2013.
9780470673386 (pbk.)
Licensed for access by U. of T. users.
general note
Rev. ed. of: Improving patient care / Richard Grol, Michel Wensing, and Martin Eccles. 2005.
catalogue key
Includes bibliographical references and index.
A Look Inside
Main Description
This book provides a model for health professionals, policy makers and researchers to assess new techniques and select and implement change in their own organizations. The new edition offers a different, more logical order in the chapters, an update of the scientific literature in all chapters, new chapters on patient safety and patient-centered strategies for change, and new, up-to-date examples for research and practice.
Main Description
As innovations are constantly being developed within health care, it can be difficult both to select appropriate new practices and technologies and to successfully adopt them within complex organizations. It is necessary to understand the consequences of introducing change, how to best implement new procedures and techniques, how to evaluate success and to improve the quality of patient care. This comprehensive guide allows you to do just that. Improving Patient Care, 2nd edition provides a structure for professionals and change agents to implement better practices in health care. It helps health professionals, managers, policy makers and researchers to assess new techniques and select and implement change in their organizations. This new edition includes recent evidence and further coverage on patient safety and patient centred strategies for change. Written by an international expert author team, Improving Patient Care is an established standard text for postgraduate students of health policy, health services and health management. The strong author team are global professors involved in managing research and development in the field of quality improvement, evidence-based practice and guidelines, quality assessment and indicators to improve patient outcomes through receiving appropriate healthcare.
Bowker Data Service Summary
This title provides a model for health professionals, policy makers and researchers to assess new techniques and select and implement change in their own organisations. The new edition offers an update of the scientific literature in all chapters and more.
Table of Contents
List of Contributorsp. xi
Introductionp. xiii
Principles of Implementation of Changep. 1
Implementation of change in healthcare: a complex problemp. 3
Introductionp. 4
The implementation problemp. 5
Various approaches to the implementation of improvements in patient carep. 8
What is implementation?p. 10
Which improvements are advisable?p. 13
A systematic approach to "sustainable change"p. 14
Referencesp. 15
Theories on implementation of change in healthcarep. 18
Introductionp. 19
Theories on factors related to individual professionalsp. 21
Theories on factors related to social interaction and contextp. 23
Theories on factors related to the organizational contextp. 27
Theories on the influence of economic factorsp. 33
Conclusionsp. 33
Referencesp. 36
Effective implementation of change in healthcare: a systematic approachp. 40
Elements of effective implementationp. 41
The "Implementation of Change Model"p. 45
Developing a proposal and targets for changep. 47
Assessment of performancep. 48
Analysis of the target group and settingp. 48
Development or selection of improvement strategiesp. 54
Development, testing, and execution of an implementation planp. 55
Sustainable change: integration of change into practice routinesp. 56
Evaluation and (possible) adaptations to the planp. 57
Planning of the implementation processp. 58
Conclusionsp. 59
Referencesp. 60
Planning and organizing the change processp. 64
Introductionp. 65
A motivated team comprising all relevant expertisep. 65
Creating a context for changep. 67
Involving the target group in the planp. 71
Leaders and key figuresp. 72
Project management: time schedule and responsibilitiesp. 73
Resources and supportp. 74
Conclusionsp. 74
Referencesp. 74
Guidelines and Innovationsp. 77
Characteristics of successful innovationsp. 79
Introductionp. 79
Various types of improvements require various types of change proposalsp. 81
Characteristics of innovations that promote implementationp. 84
Form and presentationp. 87
Involvement of the target group and local adaptionp. 88
Conclusionsp. 88
Referencesp. 89
Clinical practice guidelines as a tool for improving patient carep. 91
Introductionp. 92
Aims of guidelinesp. 92
Potential benefits and limitations of guidelinesp. 93
Development of effective guidelinesp. 95
Quality of guidelines: criteria for effective guidelinesp. 107
International collaboration in guideline developmentp. 109
Conclusionp. 109
Referencesp. 110
Assessment of Performancep. 115
Quality and safety of care: the role of indicatorsp. 117
Introductionp. 118
Indicators: typology and domainsp. 120
Method to define a set of indicatorsp. 122
Selecting or developing a preliminary set of indicatorsp. 122
Finding consensus among target usersp. 123
Testing the indicators empiricallyp. 125
Create a feedback reportp. 128
Use and effect of quality indicatorsp. 129
Increased focus on outcome indicatorsp. 130
Conclusionp. 131
Referencesp. 131
Websitesp. 135
Problem Analysisp. 137
Determinants of changep. 139
Introductionp. 140
Analysis of stakeholdersp. 140
Determinants of changep. 142
Subgroups in the target populationp. 147
Conclusionsp. 148
Referencesp. 148
Methods to identify determinants of change in healthcarep. 151
Introductionp. 152
Interviewsp. 152
Surveysp. 154
Observationp. 156
Data analysisp. 158
Goals for improvementp. 160
Conclusionsp. 162
Referencesp. 162
Strategies for Changep. 165
Development and selection of strategies for improving patient carep. 167
Introductionp. 168
Development of methods to design implementation strategiesp. 169
Selection of implementation strategiesp. 172
Facilitating versus controlling methodsp. 175
Implementation strategies in the different phases of changep. 177
Subgroups within the target groupp. 180
The effectiveness of different strategies and interventionsp. 181
Conclusionsp. 182
Referencesp. 183
Dissemination of innovationsp. 185
Introductionp. 186
Mass media approachp. 187
The "personal" approachp. 190
Conclusionp. 194
Referencesp. 194
Educational strategiesp. 197
Introductionp. 197
Types of educational strategiesp. 198
Effectiveness of educationp. 200
Determinants of the effectiveness of educationp. 204
Discussion and conclusionsp. 206
Referencesp. 207
Feedback and remindersp. 210
Introductionp. 211
Definitions of feedback and remindersp. 213
Research into the effects of feedback and remindersp. 216
Determinants of the effects of feedback and remindersp. 216
Conclusionsp. 221
Referencesp. 221
Patient-focused strategiesp. 224
Introductionp. 225
Care seeking behaviorp. 225
Provider selectionp. 228
Active participationp. 229
Feedback on professional performance and care deliveryp. 234
Conclusionsp. 235
Referencesp. 236
Organizational implementation strategies for changep. 240
Introductionp. 240
Revision of professional rolesp. 241
Enhanced patient care teamsp. 243
Knowledge management (use of information technology)p. 243
Quality managementp. 245
Integrated carep. 248
Conclusionsp. 248
Referencesp. 250
Patient safety and risk preventionp. 254
Introductionp. 254
Causes of incidentsp. 256
Measuring and analyzing incidentsp. 256
Development and selection of safety interventionsp. 260
Effective interventions to improve safetyp. 261
Conclusionsp. 265
Referencesp. 265
Economic and policy strategies for implementation of changep. 269
Introductionp. 270
Financial reimbursement of healthcare providersp. 270
Pay for performancep. 272
Financial risk for patientsp. 273
Enhanced transparency of healthcare qualityp. 274
Enhanced competitionp. 274
National policiesp. 275
Conclusionsp. 276
Referencesp. 276
Multifaceted strategies for improvementp. 278
Introductionp. 279
What is a multifaceted strategy for improvement?p. 279
Multifaceted strategies: what do they combine?p. 279
Multifaceted strategies: what works?p. 279
Multifaceted strategies: does "tailoring" work better?p. 282
Multifaceted strategies: does "more" work better?p. 283
Multifaceted strategies: which composition of strategies is effective?p. 284
Conclusionsp. 286
Referencesp. 286
Organization and Evaluationp. 289
Planning of change implementationp. 291
Introductionp. 292
Development of the plan according to phases in the change processp. 293
Planning of activities for different levels of carep. 295
Planning of activities over timep. 296
Incorporating the implementation plan into existing activitiesp. 297
Testing of the implementation strategiesp. 298
Setting goals for evaluationp. 299
Integration and embedding of new practice into routines and organizationp. 300
Conclusionsp. 301
Referencesp. 302
Impact of implementation strategies: controlled studiesp. 304
Introductionp. 305
A framework for evaluating implementation strategiesp. 308
Randomized designsp. 309
Non-randomized designsp. 319
Conclusionsp. 321
Referencesp. 321
Observational evaluation of implementation strategiesp. 324
Introductionp. 325
Designs for observational evaluationsp. 325
Studies with a few large clustersp. 326
Cohort studies with reference groupp. 327
Cohort studies without reference groupp. 327
Cross-sectional studiesp. 328
Case studiesp. 329
Developmental researchp. 330
Data analysisp. 331
Conclusionsp. 331
Referencesp. 331
Process evaluation of implementation strategiesp. 333
Introductionp. 334
Strategy fidelity and effectivenessp. 335
Process evaluation and implementation strategiesp. 335
What to measure?p. 338
How to measure?p. 344
Conclusionsp. 348
Referencesp. 348
Economic evaluation of implementation strategiesp. 350
Introductionp. 351
The basics of economic evaluationp. 351
Types of economic evaluationp. 352
Policy cost-effectivenessp. 354
Framing economic evaluationsp. 356
Cost analysisp. 357
Sensitivity analysis, modeling, and budget impactp. 361
Conclusionsp. 362
Referencesp. 363
Indexp. 365
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