Improving Patient Care: The Implementation of Change in Clinical Practice

Author: Richard Grol


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  • ISBN: 9780750688192
  • Author: Richard Grol
  • Publ Date: 2004-11-23
  • Edition:
  • Pages: 296
  • Imprint:
  • Status: ACT
  • ID - 68777

Table of Contents :

Introduction (Richard Grol) 1. Implementation of changes in practice(Richard Grol) 2. Theories on implementation of change in healthcare (Richard Grol, Marlies Hulscher, Michel Wensing, Martin Eccles) 3. Effective implementation: a model (Richard Grol, Michel Wensing) 4. Characteristics of successful innovations (Richard Grol, Michel Wensing) 5. Clinical guidelines as a tool for implementing change in patient care (Jako Burgers, Richard Grol, Martin Eccles) 6. Determinants of effective change (Michel Wensing, Richard Grol) 7. Methods to identify implementation problems (Michel Wensing, Richard Grol) 8. Selection of strategies (Richard Grol, Michel Wensing) 9. Dissemination of innovations (Richard Grol, Michel Wensing) 10. Educational interventions (Michel Wensing, Richard Grol) 11. Feedback and reminders (Trudy van der Weijden, Richard Grol) 12. Organisational and financial interventions (Michel Wensing, Niek Klazinga, Niek Klazinga, Richard Grol) 13. Patient-mediated stategies (Michel Wensing, Glyn Elwyn, Richard Grol) 14. Multifaceted interventions (Michel Wensing, Richard Grol) 15. Effective organisation of the implementation(Richard Grol) 16. Measuring changes in patient care: development and use of indicators (Joze Braspenning, Stephen Campbell, Richard Grol) 17. Experimental evaluations of change and improvement strategies (Martin Eccles, Jeremy Grimshaw, Marion Campbell, Craig Ramsay) 18. Observational evaluations of implementation strategies(Michel Wensing, Martin Eccles, Richard Grol) 19. Process evaluation of change interventions (Marlies Hulscher, Miranda Laurant, Richard Grol) 20. Economic evaluation of implementation strategies (Johan L Severens, Jody Martens and Michel Wensing) Epilogue (Richard Grol)


This book provides readers with information on how to promote the implementation of valuable new and existing insights and how procedures can best be designed to contribute to optimal patient care. The scope of the book can be described in five sections. Section 1 Principles of implementation, provides an introduction to the subject and covers the theoretical basis of the subject. Section 2 describes the characteristics of successful innovations and discusses clinical practice guidelines as a tool for improvements in health care. Section 3 covers diagnostic analysis - the methods of examining why change is or is not happening and includes factors influencing implementation of change and a description and discussion of the methods to identify obstacles to change. Section 4 covers the range of currently considered or used interventions and strategies to achieve the implementation of change. This section includes educational interventions, feedback and reminders, organisational and financial interventions, patient-oriented interventions and multifaceted interventions. Section 5 shows how to take the strategies and use them in healthcare systems and includes planning the process, measuring performance, the role and conduct of rigorous evaluations, the role and conduct of small scale evaluations, and economic evaluations. The editor and contributors of this book are prominent international researchers in the area of implementation research and have a wide range of experience across all the areas covered. Health care professionals, researchers and policy makers who want to set up improvements and change projects in health care will find this book invaluable.


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