scholarly journals The implementation process of the Confident Birth method in Swedish antenatal education: opportunities, obstacles and recommendations

2020 ◽  
Author(s):  
Sofia Jansson ◽  
Sepideh Farahshoor ◽  
Karolina Linden ◽  
Malin Bogren
Keyword(s):  
Implementation Process ◽  
Lessons Learned ◽  
Successful Implementation ◽  
First Line ◽  
Line Managers ◽  
Antenatal Education ◽  
Individual Interviews ◽  
Information And Communication ◽  
Antenatal Clinics ◽  
Inner Setting

Summary Antenatal clinics in western Sweden have recently invested in a birth method called Confident Birth. In this study, we investigate midwives’ and first line managers’ perceptions regarding the method, and identify opportunities and obstacles in its implementation. Semi-structured individual interviews were conducted with ten midwives and five first line managers working in 19 antenatal clinics in western Sweden. The Consolidated Framework for Implementation Research was used in a directed content analysis approach. Intervention Characteristics—such as perceptions about the Confident Birth method—were found to have equipped the midwives with coping strategies that were useful for expecting parents during birth. Outer Setting—the method was implemented to harmonize the antenatal education, and provided a mean for a birth companionship of choice. Inner setting—included time-consuming preparations and insufficient information at all levels, which affected the implementation. Characteristics of individuals—, such as knowledge and believes in the method, where trust in the method was seen as an opportunity, while long experience of teaching other birth preparatory methods, affected how the Confident Birth method was perceived. Process—such as no strategy for ensuring that the core of the method remained intact or plans for guiding its implementation were major obstacles to successful implementation. The findings speak to the importance of adequate planning, time, information and communication throughout the process to have a successful implementation. Based on lessons learned from this study, we have developed recommendations for successful implementation of interventions, such as the Confident Birth, in antenatal care settings.

scholarly journals Experiences of the Initial Phase Implementation of the STAMINA-Model in Perioperative Context Addressing Environmental Issues Systematically—A Qualitative Study

2020 ◽  
Vol 17 (9) ◽  
pp. 3037
Author(s):  
Erebouni Arakelian ◽  
Therese Hellman ◽  
Magnus Svartengren
Keyword(s):  
Initial Phase ◽  
Implementation Process ◽  
Environmental Issues ◽  
Successful Implementation ◽  
Key Factors ◽  
Environment Management ◽  
Individual Interviews ◽  
Goal Definition ◽  
Role Description ◽  
Passive Attitude

(1) Background: Challenges in perioperative settings put demands on staff working with systematic work environment management. A support model, STAMINA (Structured and Time-effective Approach through Methods for an Inclusive and Active working life), was implemented in a hospital in Sweden, to help staff address environmental issues systematically. The aim was to describe the experiences of the initial phase of implementation of the adapted STAMINA model in perioperative context. (2) Methods: Qualitative individual interviews were held with 14 managers and employees (three men and 11 women). Data were analysed by systematic text condensation. (3) Results: Five themes were identified: Limited knowledge of the model and the implementation process; scepticism, lack of confidence in the model and a passive attitude; the model offered increased participation; the culture in the organization—to understand one’s role as employees and managers; and endurance and feedback are key factors for success in the implementation process. (4) Conclusions: Scepticism turned to positive attitude by recognising that the STAMINA model offered increased participation. In order to have successful implementation, the organisational culture must be taken into consideration by giving the employees increased responsibilities and timely feedbacks. Role description, goal definition, feedback, and sticking to one model are key factors for success.

scholarly journals Lessons Learned from Implementation of Information and Communication Technologies in Spain’s Healthcare Services

2010 ◽  
Vol 01 (04) ◽  
pp. 363-376 ◽  
Author(s):  
D. Rojas ◽  
J. Carnicero
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Information And Communication Technologies ◽  
Communication Technologies ◽  
Care Quality ◽  
Lessons Learned ◽  
Successful Implementation ◽  
Management Culture ◽  
Information And Communication ◽  
Electronic Health

Summary Background: Spain’s health services have undertaken a number of important projects aimed at the creation of Electronic Health Records (EHR) through the incorporation of Information and Communication Technologies (ICT) into patient care practices. The objective of this endeavor is to improve care quality and efficiency and increase responsiveness to the population‘s needs and demands. Between 2006-2009 over 300 million Euro were invested in projects of this type. Objective: To better understand the success criteria, the difficulties encountered and certain issues that must be kept in mind to ensure successful implementation of ICT projects in health organizations, based on Spain‘s experiences in this field. Methods: The projects’ results are analyzed using the criteria of compliance with the expected scope, cost and time frame. Results: The results can be considered satisfactory in primary care facilities, where almost 90% of Spain‘s general practitioners, pediatricians and primary care nurses are using electronic health record (EHR) systems. In hospitals EHR implementation is more uneven. Over 40% of Spanish primary care centers and 42% of pharmacies are using electronic prescription (the information system that connects the physician to the dispensing pharmacy and the dispensing pharmacy to the payer). Discussion: All of Spain’s health services are currently carrying out projects involving ICT application in healthcare, and a priori the benefits of ICT are not questioned. However, the costs and time frames required for these projects are clearly surpassing initial expectations, while the benefits perceived by both professionals and institutions remain limited. This situation may be due in part to the absence of a project management culture in the health services, which has led them to pay insufficient attention to the main difficulties and key issues related to the implementation of EHR.

Evaluating the implementation of computerized prescriber order entry (CPOE) for systemic treatment (ST) in Ontario.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 54-54
Author(s):  
Sharon Gradin ◽  
Nancy Wolf ◽  
Marta Yurcan ◽  
Tim Yardley ◽  
Leonard Kaizer ◽  
...  
Keyword(s):  
Success Factors ◽  
Systemic Treatment ◽  
Peer Group ◽  
Implementation Process ◽  
Error Rates ◽  
Lessons Learned ◽  
Professional Communication ◽  
Successful Implementation ◽  
Qualitative Feedback ◽  
Transcription Error

54 Background: A successful effort was led in Ontario to increase ST CPOE adoption from 73% to 92% to support safety of patients receiving complex systemic treatment. This work included implementation at 19 hospitals from 2011-2013. The implementation process included identification of multidisciplinary team champions, baseline workflow analysis and development of a future desired state. Findings from this project’s benefits evaluation are presented. Methods: Each hospital was required to collect pre and post implementation measurements for medication errors, transcription errors and order clarity/completeness. Six months post implementation, a semi-structured telephone interview was conducted with representative hospitals (9/19) to obtain qualitative feedback on how implementation impacted workflow, inter-professional practice and workload. Results: Hospitals that implemented showed: 1) decrease in overall medication error rates. 2) decrease in transcription error rates and 3) decrease in number of unclear or incomplete orders. Qualitative feedback from hospital leads indicated that the “future desired” workflow was achieved by all. Most hospital respondents indicated that clarity of inter-professional communication regarding orders improved and in most cases overall workload did not increase. Conclusions: The findings reinforce the benefit associated with implementation of ST CPOE in outpatient settings. Lessons learned in Ontario can be leveraged to support successful implementation of ST CPOE in other jurisdictions. Critical implementation success factors included: 1) leadership and multi-disciplinary involvement; 2) provision of funding and cost sharing; 3) facilitation of process improvement through established methodologies, 4) knowledge transfer and peer group led education and training sessions. [Table: see text]

Managers’ learning process during a health-promoting leadership intervention

2019 ◽  
Vol 119 (5/6) ◽  
pp. 350-365
Author(s):  
Åsa Tjulin ◽  
Bodil Landstad ◽  
Stig Vinberg ◽  
Andrea Eriksson ◽  
Emma Hagqvist
Keyword(s):  
Public Sector ◽  
Workplace Health Promotion ◽  
County Council ◽  
First Line ◽  
Line Managers ◽  
Content Type ◽  
Individual Interviews ◽  
Health Promoting ◽  
Public Sector Managers ◽  
Leadership Intervention

Purpose The increasingly demanding psychosocial working conditions in Swedish public sector workplaces call for implementation of workplace health promotion (WHP) interventions. There is a need to increase first-line public sector managers’ capacities for health-promoting leadership. The purpose of this paper is to investigate first-line managers’ experiences of participating in an intervention aimed at strengthening health-promoting leadership. More precisely, the aim is to study what obstacles and prerequisites the intervention have for their learning processes to become health-promoting managers. Design/methodology/approach A qualitative study in Northern Sweden at workplaces in the county council and municipalities was conducted. The data were gathered through individual interviews with 18 participating first-line managers. Inductive-content analysis was used to analyse the data. Findings The results identify time for reflection and collegial discussions about leadership as prerequisites for learning about health-promoting leadership. Managers experienced the intervention as a confirmation of the leadership behaviours already gained. However, the health-promoting leadership intervention was seen as a contradiction, since organisational prerequisites to implement WHP measures were perceived to be lacking. The managers were not involved in the planning of the intervention and questioned why the organisation did not involve them more when the educational activities were created. Originality/value When the organisation understands how and when its managers learn, what they need and want to learn about WHP, and what they already know, tailored participatory interventions can be facilitated that consider the unique prerequisites for the particular organisation.

Development and Implementation of Computerized Clinical Guidelines: Barriers and Solutions

2002 ◽  
Vol 41 (05) ◽  
pp. 435-442 ◽  
Author(s):  
M. H. Trivedi ◽  
J. K. Kern ◽  
A. Marcee ◽  
B. Grannemann ◽  
B. Kleiber ◽  
...  
Keyword(s):  
User Satisfaction ◽  
Clinical Performance ◽  
Implementation Process ◽  
User Feedback ◽  
Lessons Learned ◽  
Successful Implementation ◽  
End User ◽  
Computerized Decision Support ◽  
Technical Problems ◽  
Implementation Guidelines

SummaryNext, the article discusses the need to incorporate the use of surveys, questionnaires, or rating instruments for the collection of end-user feedback during and after the implementation process. A description of the types of rating instruments that will facilitate the assessment of user satisfaction is provided. Initial results from physician feedback during the implementation of our prototype are discussed. Research indicates that computerized decision support systems (CDSSs) can improve clinical performance and patient outcomes, and yet CDSSs are not in widespread use. Physician guidelines, in general, face barriers in implementation. Guidelines in a computerized format can overcome some of the barriers to conventional text-form guidelines; however, computerized programs have novel aspects that have to be considered, aspects such as technical problems/support and user interface issues that can act as barriers. Though the literature points out that human, organizational, and technical issues can act as barriers in the implementation of CDSSs, studies clearly indicate that there are methods that can overcome these barriers and improve CDSS acceptance and use. These methods come from lessons learned from a variety of CDSS implementation ventures. Notably, most of the methods that improve acceptance and use of a CDSS require feedback and involvement of end-users. Measuring and addressing physician or user attitudes toward the computerized support system has been shown to be important in the successful implementation of a CDSS. This article discusses: 1) the barriers of implementation of guidelines in general and of CDSSs; 2) the importance of the physician’s role in development, implementation, and adherence; 3) methods that can improve CDSS acceptance and use; and 4) the types of tools needed to obtain end-user feedback.

Evidence-based eHealth interventions for caregivers of people with dementia (Myinlife and Partner in Balance): Evaluation of implementations in municipality contexts (Preprint)

2020 ◽  
Author(s):  
Hannah Liane Christie ◽  
Lizzy Mitzy Maria Boots ◽  
Huibert Johannes Tange ◽  
Frans Rochus Josef Verhey ◽  
Marjolein Elizabeth de Vugt
Keyword(s):  
Self Efficacy ◽  
Measurement Instrument ◽  
Implementation Process ◽  
Successful Implementation ◽  
Evidence Based ◽  
Multiple Sources ◽  
Target Groups ◽  
Face To Face ◽  
People With Dementia ◽  
Implementation Context

BACKGROUND Very few evidence-based eHealth interventions for caregivers of people with dementia are implemented into practice. Municipalities are one promising context to implement these interventions, due to their available policy and innovation incentives regarding (dementia) caregiving and prevention. In this study, two evidence-based eHealth interventions for caregivers of people with dementia (Partner in Balance and Myinlife) were implemented in eight municipalities in the Euregion Meuse-Rhine. OBJECTIVE This study’s objectives were to (1.) evaluate this implementation and (2.) investigate determinants of successful implementation. METHODS This study collected eHealth usage data, Partner in Balance coach evaluation questionnaires, and information on implementation determinants. This was done by conducting interviews with the municipality officials, based on the Measurement Instrument for Determinants of Implementation (MIDI). This data from multiple sources and perspectives was integrated and analysed to form a total picture of the municipality implementation process. RESULTS The municipality implementation of Partner in Balance and Myinlife showed varying levels of success. In the end, three municipalities planned to continue the implementation of Partner in Balance, while none planned to continue the implementation of Myinlife. The two Partner in Balance municipalities that did not consider the implementation to be successful, viewed the implementation as an external project. For Myinlife, it was clear that more face-to-face contact was needed to engage the implementing municipality and the target groups. Successful implementations were linked to implementer self-efficacy CONCLUSIONS The experiences of implementing these interventions suggested that this implementation context was feasible regarding the required budget and infrastructure. The need to foster sense of ownership and self-efficacy in implementers will be integrated into future implementation protocols, as part of standard implementation materials for municipalities and organisations implementing Myinlife and Partner in Balance.

Leadership and school self-evaluation in Irish-medium immersion: A roadmap for success

2021 ◽  
pp. 174114322110152
Author(s):  
TJ Ó Ceallaigh ◽  
Aoife Ní Shéaghdha
Keyword(s):  
Quality Indicators ◽  
Cognitive Skills ◽  
Best Practice ◽  
Research Question ◽  
Evaluation Process ◽  
Successful Implementation ◽  
Language And Literacy ◽  
Evaluation Tool ◽  
Self Evaluation ◽  
Individual Interviews

While research on Irish-medium immersion education (IME) has heralded benefits such as cognitive skills, academic achievement and language and literacy development, many studies have also identified challenges to its successful implementation. Immersion-specific research-validated tools can help school leaders navigate the school self-evaluation journey, critically review and evaluate the quality of aspects of their school’s provision and plan for improvement. This paper reports on one theme, leadership, from a larger study, Quality indicators of best practice in Irish-medium immersion (Ó Ceallaigh and Ní Shéaghdha, 2017). Qualitative in nature, the study was guided by the following research question: What are IME educators’ perceptions of best practices in IME?. The study explored 120 IME educators’ perceptions of best practice in IME to inform the development of IME quality indicators. Individual interviews and focus group interviews were utilised to collect data. Data analysis revealed particular themes related to best IME leadership practices. Findings in turn informed the design of an evidence-informed school self-evaluation tool for IME settings. The various functions of the tool will be explored with a particular emphasis on building teaching and leadership capacity in IME through the school self-evaluation process.

Experiences of job demand and control: A study of first line managers in for-profit psychiatric and addiction care

Work ◽  
2021 ◽  
pp. 1-9
Author(s):  
Linda Widar ◽  
Erika Wall ◽  
Sven Svensson
Keyword(s):  
First Line ◽  
Line Managers ◽  
For Profit ◽  
Job Demand ◽  
Organizational Position ◽  
Wide Range ◽  
Line Manager ◽  
Addiction Care ◽  
And Control ◽  
Demand Control

BACKGROUND: The complex position of a first line manager is characterized by heavy workload and contradictory demands. Little is known about how first line managers experience demand and control in their work. OBJECTIVES: The aim of this study was to explore experiences of demand and control among first line managers within psychiatric and addiction care. METHOD: In the present study, interviews with ten managers in for-profit psychiatric and addiction care in Sweden were analyzed with a phenomenographic approach. RESULTS: The managers experiences of demand and control implied varied and extensive responsibilities for a wide range of professions; regulation by organizational, economic, and political frameworks; creating balance in their work; and handling the emergence and consequences of acute crisis. These experiences of demand and control involved high and contradictory demands together with coexisting high and low levels of control. Many of their work characteristics could be described in terms of both demand and control. CONSLUSION: The first line managers experiences of demand and control are more complex than implied by the job demand control theory. Our results suggest that the organizational position and branch should be considered when identifying health hazards in the work environment of first line managers.

scholarly journals Implementation and effectiveness of drive-through medication pick-up and home delivery services. A patient safety initiative during COVID-19 pandemic

2021 ◽  
pp. 251604352110090
Author(s):  
Haneen K AlAbbasi ◽  
Shabeer A Thorakkattil ◽  
Syed I Mohiuddin ◽  
Habib S Nemr ◽  
Rita Jabbour ◽  
...  
Keyword(s):  
Patient Safety ◽  
Implementation Process ◽  
Home Delivery ◽  
Successful Implementation ◽  
Social Distancing ◽  
Pharmacy Department ◽  
Ensure Patient Safety ◽  
Number Of Patients ◽  
Delivery Services ◽  
Safety Initiative

Introduction With the emergence of the first COVID-19 case in Saudi Arabia, Johns Hopkins Aramco Healthcare has immediately executed the appropriate protocols in response to this severe global crisis. The pharmacy department at Johns Hopkins Aramco Healthcare continues to play an essential role in providing the safest, efficient, and effective service to its eligible patients. In response to the COVID-19 pandemic, the pharmacy department acted by implementing a drive-through pharmacy and home delivery services as new person-centered services to ensure patient safety. These two new services were initiated to protect both the pharmacist and the patient from COVID-19 infections as they ensure social distancing and reduce patients’ visits to the walk-in pharmacies, hence providing valuable and convenient services during this pandemic. Objective This article aims to describe the implementation processes and effectiveness of drive-through medication pick-up and home-delivery services as a patient safety initiative during the COVID-19 pandemic. Method The implementation process of the drive-through and home delivery services are explained in detail. The utilization of these two services is evaluated by measuring the number of patients and prescriptions between April 2020 and August 2020. Result The increased utilization of drive-through medication pick-up and home delivery services in terms of the number of patients and prescriptions ensures patient safety by minimizing infection risk. Conclusion The increase in the utilization of drive-through medication pick-up and home delivery services reflects its successful implementation during the COVID-19 pandemic. Both services meet the pandemic’s social-distancing requirements and minimize risks of infections, which will ensure patient safety during the COVID-19 pandemic.

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