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Open Access 01-12-2012 | Study protocol

Sustainability of healthcare innovations (SUSHI): long term effects of two implemented surgical care programmes (protocol)

Authors: Stephanie M C Ament, Freek Gillissen, José M C Maessen, Carmen D Dirksen, Trudy van der Weijden, Maarten F von Meyenfeldt

Published in: BMC Health Services Research | Issue 1/2012

Abstract

Background

Two healthcare innovations were successfully implemented using different implementation strategies. First, a Short Stay Programme for breast cancer surgery (MaDO) was implemented in four early adopter hospitals, using a hospital-tailored implementation strategy. Second, the Enhanced Recovery After Surgery (ERAS) programme for colonic surgery was implemented in 33 Dutch hospitals, using a generic breakthrough implementation strategy. Both strategies resulted in a shorter hospital length of stay without a decrease in quality of care. Currently, it is unclear to what extent these innovative programmes and their results have been sustained three to five years following implementation. The aim of the sustainability of healthcare innovations (SUSHI) study is to analyse sustainability and its determinants using two implementation cases.

Methods

This observational study uses a mixed methods approach. The study will be performed in 14 hospitals in the Netherlands, from November 2010. For both implementation cases, the programme aspects and the effects will be evaluated by means of a follow-up measurement in 160 patients who underwent breast cancer surgery and 300 patients who underwent colonic surgery. A policy cost-effectiveness analysis from a societal perspective will be performed prospectively for the Short Stay Programme for breast cancer surgery in 160 patients. To study determinants of sustainability key professionals in the multidisciplinary care processes and implementation change agents will be interviewed using semi-structured interviews.

Discussion

The concept of sustainability is not commonly studied in implementation science. The SUSHI study will provide insight in to what extent the short-term implementation benefits have been maintained and in the determinants of long-term continuation of programme activities.

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Grol R, Wensing M: What drives change? Barriers to and incentives for achieving evidence-based practice. Med J Aust. 2004, 180: S57-S60.PubMed

Wilson KD, Kurz RS: Bridging implementation and institutionalization within organizations: proposed employment of continuous quality improvement to further dissemination. J Public Health Manag Pract. 2008, 14: 109-116.CrossRefPubMed

Stetler CB, McQueen L, Demakis J, Mittman BS: An organizational framework and strategic implementation for system-level change to enhance research-based practice: QUERI Series. Implement Sci. 2008, 3: 30-10.1186/1748-5908-3-30.CrossRefPubMedPubMedCentral

Grimshaw JM, Eccles MP, Walker AE, Thomas RE: Changing physicians’ behavior: what works and thoughts on getting more things to work. J Contin Educ Health Prof. 2002, 22: 237-243. 10.1002/chp.1340220408.CrossRefPubMed

Schuster MA, McGlynn EA, Brook RH: How good is the quality of health care in the United States?. Milbank Q. 1998, 76: 563-509.CrossRef

Grol R, Grimshaw J: From best evidence to best practice: effective implementation of change in patients’ care. Lancet. 2003, 362: 1225-1230. 10.1016/S0140-6736(03)14546-1.CrossRefPubMed

Grimshaw J, Eccles M, Tetroe J: Implementing clinical guidelines: current evidence and future implications. J Contin Educ Health Prof. 2004, 24 (Suppl 1): S31-S37.CrossRefPubMed

Baker R, Camosso-Stefinovic J, Gillies C, Shaw EJ, Cheater F, Flottorp S, Robertson N: Tailored interventions to overcome identified barriers to change: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2010, CD005470-3

van Bokhoven MA, Kok G, van der Weijden T: Designing a quality improvement intervention: a systematic approach. Qual Saf Health Care. 2003, 12: 215-220. 10.1136/qhc.12.3.215.CrossRefPubMedPubMedCentral

10.

Sculpher M: Evaluating the cost-effectiveness of interventions designed to increase the utilization of evidence-based guidelines. Fam Pract. 2000, 17 (Suppl 1): S26-S31.CrossRefPubMed

11.

Shediac-Rizkallah MC, Bone LR: Planning for the sustainability of community-based health programs: conceptual frameworks and future directions for research, practice and policy. Health Educ Res. 1998, 13: 87-108. 10.1093/her/13.1.87.CrossRefPubMed

12.

Scheirer M: Is sustainability possible? A review and commentary on empirical studies of program sustainability. Am J Eval. 2005, 26: 320-347. 10.1177/1098214005278752.CrossRef

13.

Pluye P, Potvin L, Denis JL, Pelletier J: Program sustainability: focus on organizational routines. Health Promot Int. 2004, 19: 489-500. 10.1093/heapro/dah411.CrossRefPubMed

14.

Duckers ML, Wagner C, Vos L, Groenewegen PP: Understanding organisational development, sustainability, and diffusion of innovations within hospitals participating in a multilevel quality collaborative. Implement Sci. 2011, 6: 18-10.1186/1748-5908-6-18.CrossRefPubMedPubMedCentral

15.

Gruen RL, Elliott JH, Nolan ML, Lawton PD, Parkhill A, McLaren CJ, Lavis JN: Sustainability science: an integrated approach for health-programme planning. Lancet. 2008, 372: 1579-1589. 10.1016/S0140-6736(08)61659-1.CrossRefPubMed

16.

Rabin BA, Brownson RC, Haire-Joshu D, Kreuter MW, Weaver NL: A glossary for dissemination and implementation research in health. J Public Health Manag Pract. 2008, 14: 117-123.CrossRefPubMed

17.

NHS: Sustainability and its relationship with spread and adoption, General improvement skills. 2007, Conventry, UK: Improvement NIfIa ed

18.

Wiltsey S, Kimberly J, Cook N, Calloway A, Castro F, Charns M: The sustainability of new programs and innovations: a review of the empirical literature and recommendations for future research. Implement Sci. 2012, 7: 17-10.1186/1748-5908-7-17.CrossRef

19.

de Kok M, Dirksen CD, Kessels AG, van der Weijden T, van de Velde CJ, Roukema JA, Bell AV, van der Ent FW, von Meyenfeldt MF: Cost-effectiveness of a short stay admission programme for breast cancer surgery. Acta Oncol. 2010, 49: 338-346. 10.3109/02841861003610192.CrossRefPubMed

20.

de Kok M, Frotscher CN, van der Weijden T, Kessels AG, Dirksen CD, van de Velde CJ, Roukema JA, Bell AV, van der Ent FW, von Meyenfeldt MF: Introduction of a breast cancer care programme including ultra short hospital stay in 4 early adopter centres: framework for an implementation study. BMC Cancer. 2007, 7: 117-10.1186/1471-2407-7-117.CrossRefPubMedPubMedCentral

21.

de Kok M, Scholte RW, Sixma HJ, van der Weijden T, Spijkers KF, van de Velde CJ, Roukema JA, van der Ent FW, Bell AV, von Meyenfeldt MF: The patient’s perspective of the quality of breast cancer care. The development of an instrument to measure quality of care through focus groups and concept mapping with breast cancer patients. Eur J Cancer. 2007, 43: 1257-1264. 10.1016/j.ejca.2007.03.012.CrossRefPubMed

22.

de Kok M, van der Weijden T, Kessels A, Dirksen C, van de Velde C, Roukema J, van der Ent F, Bell A, von Meyenfeldt M: Implementation of an ultra-short-stay program after breast cancer surgery in four hospitals: perceived barriers and facilitators. World J Surg. 2008, 32: 2541-2548. 10.1007/s00268-007-9357-z.CrossRefPubMed

23.

Fearon KC, Ljungqvist O, Von Meyenfeldt M, Revhaug A, Dejong CH, Lassen K, Nygren J, Hausel J, Soop M, Andersen J, Kehlet H: Enhanced recovery after surgery: a consensus review of clinical care for patients undergoing colonic resection. Clin Nutr. 2005, 24: 466-477. 10.1016/j.clnu.2005.02.002.CrossRefPubMed

24.

Maessen J, Dejong CH, Hausel J, Nygren J, Lassen K, Andersen J, Kessels AG, Revhaug A, Kehlet H, Ljungqvist O, et al: A protocol is not enough to implement an enhanced recovery programme for colorectal resection. Br J Surg. 2007, 94: 224-231. 10.1002/bjs.5468.CrossRefPubMed

25.

Maessen JM, Dejong CH, Kessels AG, von Meyenfeldt MF: Length of stay: an inappropriate readout of the success of enhanced recovery programs. World J Surg. 2008, 32: 971-975. 10.1007/s00268-007-9404-9.CrossRefPubMedPubMedCentral

26.

Oostenbrink JB, Koopmanschap MA, Rutten FF: Standardisation of costs: the Dutch Manual for Costing in economic evaluations. Pharmacoeconomics. 2002, 20 (7): 443-454. 10.2165/00019053-200220070-00002.CrossRefPubMed

27.

Severens JL: Value for money of changing healthcare services? Economic evaluation of quality improvement. Qual Saf Health Care. 2003, 12: 366-371. 10.1136/qhc.12.5.366.CrossRefPubMedPubMedCentral

28.

The EuroQol Group: EuroQol--a new facility for the measurement of health-related quality of life. Health Policy. 1990, 16: 199-208.CrossRef

29.

Efron B: Introduction to the bootstrap. 1993, New York, USA: Chapman & HallCrossRef

30.

Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC: Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009, 4: 50-10.1186/1748-5908-4-50.CrossRefPubMedPubMedCentral

31.

Rogers E: Diffusion on innovations. 2003, New York, NY: Free Press, 5th

32.

Damschroder LJ, Hagedorn HJ: A guiding framework and approach for implementation research in substance use disorders treatment. Psychol Addict Behav. 2011, 25 (2): 194-205.CrossRefPubMed

33.

Simpson DD, Flynn PM: Moving innovations into treatment: A stage-based approach to program change. J Subst Abuse Treat. 2007, 33: 111-120. 10.1016/j.jsat.2006.12.023.CrossRefPubMedPubMedCentral

34.

Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O: Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q. 2004, 82: 581-629. 10.1111/j.0887-378X.2004.00325.x.CrossRefPubMedPubMedCentral

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1472-6963/12/423/prepub

Title: Sustainability of healthcare innovations (SUSHI): long term effects of two implemented surgical care programmes (protocol)
Authors: Stephanie M C Ament
Freek Gillissen
José M C Maessen
Carmen D Dirksen
Trudy van der Weijden
Maarten F von Meyenfeldt
Publication date: 01-12-2012
Publisher: BioMed Central
Published in: BMC Health Services Research / Issue 1/2012
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/1472-6963-12-423

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Sustainability of healthcare innovations (SUSHI): long term effects of two implemented surgical care programmes (protocol)

Abstract

Background

Methods

Discussion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Discussion

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