Evidence map›Paper›PMID 36284324›Full record

ArticleBMC health services research2022

How to fall into a new routine: factors influencing the implementation of an admission and discharge programme in hospitals and general practices.

Johanna Forstner, Nicola Litke, Aline Weis, Cornelia Straßner, Joachim Szecsenyi, Michel Wensing

Abstract read
In one paragraph

Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
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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.

Johanna Forstner *Department of General Practice and Health Services Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, Marsilius Arkaden, Turm West, D-69120 Heidelberg, Heidelberg, 69120, Germany. johanna.forstner@med.uni-heidelberg.de.
Nicola Litke *Department of General Practice and Health Services Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, Marsilius Arkaden, Turm West, D-69120 Heidelberg, Heidelberg, 69120, Germany.
Aline WeisDepartment of General Practice and Health Services Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, Marsilius Arkaden, Turm West, D-69120 Heidelberg, Heidelberg, 69120, Germany.
Cornelia StraßnerDepartment of General Practice and Health Services Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, Marsilius Arkaden, Turm West, D-69120 Heidelberg, Heidelberg, 69120, Germany.
Joachim SzecsenyiDepartment of General Practice and Health Services Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, Marsilius Arkaden, Turm West, D-69120 Heidelberg, Heidelberg, 69120, Germany.
Michel WensingDepartment of General Practice and Health Services Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, Marsilius Arkaden, Turm West, D-69120 Heidelberg, Heidelberg, 69120, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe VESPEERA programme is a multifaceted programme to enhance information transfer between general practice and hospital across the process of hospital admission, stay and discharge. It was implemented in 7 hospitals and 72 general practices in Southern Germany. Uptake was heterogeneous and overall low. A process evaluation aimed at identifying factors associated with the implementation of the VESPEERA programme.

methodsThis was a qualitative study using semi-structured interviews in a purposeful sample of health workers in hospitals and general practices in the VESPEERA programme. Qualitative framework analysis using the Consolidated Framework for Implementation Research was performed and revealed the topic of previous and new routines to be protruding. Inductive content analysis was used for in-depth examination of stages in the process of staying in a previous or falling into a new routines.

resultsThirty-six interviews were conducted with 17 participants from general practices and 19 participants from hospitals. The interviewees were in different stages of the implementation process at the time of the interviews. Four stages were identified: Stage 1,'Previous routine and tension for change', describes the situation in which VESPEERA was to be implemented and the factors leading to the decision to participate. In stage 2,'Adoption of the VESPEERA programme', factors that influenced whether individuals decided to employ the innovation are relevant. Stage 3 comprises 'Determinants for falling into and staying in the new VESPEERA-routine' relates to actual implementation and finally, in stage 4, the participants reflect on the success of the implementation.

conclusionsThe individuals and organisations participating in the VESPEERA programme were in different stages of a process from the previous to the new routine, which were characterised by different determinants of implementation. In all stages, organisational factors were main determinants of implementation, but different factors emerged in different implementation stages. A low distinction between decision-making power and executive, as well as available resources, were beneficial for the implementation of the innovation.

trial registrationDRKS00015183 on DRKS / Universal Trial Number (UTN): U1111-1218-0992.

Indexed as

General PracticePatient DischargeHospitalizationHospitalsHumansQualitative ResearchAdmission managementDischarge managementGeneral practiceHospitalImplementationMiddle managementRoutine

Identifiers

PMID36284324
PMCPMC9598008

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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.