Evidence map›Paper›PMID 31492184›Full record

ArticleBMC health services research2019

The implementation of change model adds value to value-based healthcare: a qualitative study.

Nina Zipfel, Paul B van der Nat, Benno J W M Rensing, Edgar J Daeter, Gert P Westert, A Stef Groenewoud

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Article in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
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  5. Article
  6. Outcomes in pulmonary sarcoidosis: results of a newly implemented prednisone protocol.Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG · 2023
    Article
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  8. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Nina ZipfelDepartment of Value-based Healthcare, St. Antonius Hospital, P.O. Box 2500, 3430, EM, Nieuwegein, the Netherlands. n.zipfel@antoniusziekenhuis.nl.ORCID http://orcid.org/0000-0003-4125-6726
Paul B van der NatDepartment of Value-based Healthcare, St. Antonius Hospital, P.O. Box 2500, 3430, EM, Nieuwegein, the Netherlands.
Benno J W M RensingDepartment of Cardiology, St. Antonius Hospital, P.O. Box 2500, 3430, EM, Nieuwegein, the Netherlands.
Edgar J DaeterDepartment of Cardiothoracic Surgery, St. Antonius Hospital, P.O. Box 2500, 3430, EM, Nieuwegein, the Netherlands.
Gert P WestertRadboud university medical center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), P.O. Box 9101, 6500, HB, Nijmegen, the Netherlands.
A Stef GroenewoudRadboud university medical center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), P.O. Box 9101, 6500, HB, Nijmegen, the Netherlands.

Funding

ZonMw 842001005
6 · The paper itself

Abstract

backgroundValue-based healthcare (VBHC) is a concept that focuses on outcome measurement to contribute to quality improvement. However, VBHC does not offer a systematic approach for implementing improvement as implementation science does. The aim is to, firstly, investigate the implementation of improvement initiatives in the context of VBHC and secondly, to explore how implementation science could be of added value for VBHC and vice versa.

methodsA case study with two cases in heart care was conducted; one without the explicit use of a systematic implementation method and the other one with the use of the Implementation of Change Model (ICM). Triangulation of data from document research, semi-structured interviews and a focus group was applied to evaluate the degree of method uptake. Interviews were held with experts involved in the implementation of Case 1 (N = 4) and Case 2 (N = 7). The focus group was held with experts also involved in the interviews (N = 4). A theory-driven qualitative analysis was conducted using the ICM as a framework.

resultsIn both cases, outcome measures were seen as an important starting point for the implementation and for monitoring change. Several themes were identified as most important: support, personal importance, involvement, leadership, climate and continuous monitoring. Success factors included intrinsic motivation for the change, speed of implementation, complexity and continuous evaluation.

conclusionApplication of the ICM facilitates successful implementation of quality- improvement initiatives within VBHC. However, the practical use of the ICM shows an emphasis on processes. We recommend that monitoring of outcomes be added as an essential part of the ICM. In the discussion, we propose an implementation model that integrates ICM within VBHC.

Indexed as

Quality ImprovementCardiac Surgical ProceduresDelivery of Health CareDietary ProteinsDiffusion of InnovationHealth ServicesHumansImplementation ScienceLeadershipLongitudinal StudiesOutcome Assessment, Health CarePreoperative CareQualitative ResearchDietary ProteinsImplementation of change modelImplementation scienceOutcome improvementOutcome measurementValue-based healthcare

Identifiers

PMID31492184
PMCPMC6728951

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.