Senior onderzoeker Verpleging, Verzorging en Ouderenzorg
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Sustainment of innovations in palliative care: a survey on lessons learned from a nationwide quality improvement programme.
Veer, A.J.E. de, Fleuren, M.A.H., Vos, H., Francke, A.L. Sustainment of innovations in palliative care: a survey on lessons learned from a nationwide quality improvement programme. Journal of Pain and Symptom Management: 2020
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Context
While much is known about factors influencing short-term implementation, little is known about what factors are relevant for the long-term sustainment of innovations. In the Dutch National Quality Improvement Programme for Palliative Care, innovations were implemented in 76 implementation projects.
Objectives
To give insight into the sustainment strategies used and factors facilitating and hindering sustainment.
Methods
Online questionnaire with pre-structured and open questions sent to the contact persons for 76 implementation projects, 2 to 6.5 years after the start.
Results
Information was gathered on 63 implementation projects (response 83%). The majority of the projects took place in home care, general practices and/or nursing homes. Sustainment was attained in 60% of the implementation projects. Six often applied strategies were statistically significantly related to sustainment:
(a) realizing coherence between the innovation and the strategic policy of the organization;
(b) arranging to have a specific professional responsible for the use of the innovation;
(c) integrating the innovation into the organization's broader palliative care policy;
(d) arranging accessibility of the innovation;
(e) involving management in the implementation project;
(f) giving regular feedback about the implementation.
In three quarters of the projects, barriers and facilitators were encountered relating to characteristics of the care organizations, such as employee turnover and ratification of the project by the management.
Conclusion
Applying the six strategies enhances sustainment. The organization plays a decisive role in the sustainment of innovations in palliative care. Engaging the management team in implementation projects from early onset is of utmost importance.
While much is known about factors influencing short-term implementation, little is known about what factors are relevant for the long-term sustainment of innovations. In the Dutch National Quality Improvement Programme for Palliative Care, innovations were implemented in 76 implementation projects.
Objectives
To give insight into the sustainment strategies used and factors facilitating and hindering sustainment.
Methods
Online questionnaire with pre-structured and open questions sent to the contact persons for 76 implementation projects, 2 to 6.5 years after the start.
Results
Information was gathered on 63 implementation projects (response 83%). The majority of the projects took place in home care, general practices and/or nursing homes. Sustainment was attained in 60% of the implementation projects. Six often applied strategies were statistically significantly related to sustainment:
(a) realizing coherence between the innovation and the strategic policy of the organization;
(b) arranging to have a specific professional responsible for the use of the innovation;
(c) integrating the innovation into the organization's broader palliative care policy;
(d) arranging accessibility of the innovation;
(e) involving management in the implementation project;
(f) giving regular feedback about the implementation.
In three quarters of the projects, barriers and facilitators were encountered relating to characteristics of the care organizations, such as employee turnover and ratification of the project by the management.
Conclusion
Applying the six strategies enhances sustainment. The organization plays a decisive role in the sustainment of innovations in palliative care. Engaging the management team in implementation projects from early onset is of utmost importance.
Context
While much is known about factors influencing short-term implementation, little is known about what factors are relevant for the long-term sustainment of innovations. In the Dutch National Quality Improvement Programme for Palliative Care, innovations were implemented in 76 implementation projects.
Objectives
To give insight into the sustainment strategies used and factors facilitating and hindering sustainment.
Methods
Online questionnaire with pre-structured and open questions sent to the contact persons for 76 implementation projects, 2 to 6.5 years after the start.
Results
Information was gathered on 63 implementation projects (response 83%). The majority of the projects took place in home care, general practices and/or nursing homes. Sustainment was attained in 60% of the implementation projects. Six often applied strategies were statistically significantly related to sustainment:
(a) realizing coherence between the innovation and the strategic policy of the organization;
(b) arranging to have a specific professional responsible for the use of the innovation;
(c) integrating the innovation into the organization's broader palliative care policy;
(d) arranging accessibility of the innovation;
(e) involving management in the implementation project;
(f) giving regular feedback about the implementation.
In three quarters of the projects, barriers and facilitators were encountered relating to characteristics of the care organizations, such as employee turnover and ratification of the project by the management.
Conclusion
Applying the six strategies enhances sustainment. The organization plays a decisive role in the sustainment of innovations in palliative care. Engaging the management team in implementation projects from early onset is of utmost importance.
While much is known about factors influencing short-term implementation, little is known about what factors are relevant for the long-term sustainment of innovations. In the Dutch National Quality Improvement Programme for Palliative Care, innovations were implemented in 76 implementation projects.
Objectives
To give insight into the sustainment strategies used and factors facilitating and hindering sustainment.
Methods
Online questionnaire with pre-structured and open questions sent to the contact persons for 76 implementation projects, 2 to 6.5 years after the start.
Results
Information was gathered on 63 implementation projects (response 83%). The majority of the projects took place in home care, general practices and/or nursing homes. Sustainment was attained in 60% of the implementation projects. Six often applied strategies were statistically significantly related to sustainment:
(a) realizing coherence between the innovation and the strategic policy of the organization;
(b) arranging to have a specific professional responsible for the use of the innovation;
(c) integrating the innovation into the organization's broader palliative care policy;
(d) arranging accessibility of the innovation;
(e) involving management in the implementation project;
(f) giving regular feedback about the implementation.
In three quarters of the projects, barriers and facilitators were encountered relating to characteristics of the care organizations, such as employee turnover and ratification of the project by the management.
Conclusion
Applying the six strategies enhances sustainment. The organization plays a decisive role in the sustainment of innovations in palliative care. Engaging the management team in implementation projects from early onset is of utmost importance.
