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Title: Barriers to implementation of a redesign of information transfer and feedback in acute care: Results from a multiple case study
Authors: Van Leijen-Zeelenberg, J.E
Van Raak, A.J
Duimel-Peeters, I.G
Kroese, M.E
Brink, P.R
Ruwaard, D
Vrijhoef, H.J.M. 
Keywords: emergency medicine
feedback system
health services research
information processing
interpersonal communication
nonbiological model
patient care
patient safety
total quality management
Continuity of Patient Care
Emergency Medicine
Focus Groups
Models, Organizational
Organizational Case Studies
Patient Safety
Quality Improvement
Issue Date: 2014
Publisher: BioMed Central Ltd.
Citation: Van Leijen-Zeelenberg, J.E, Van Raak, A.J, Duimel-Peeters, I.G, Kroese, M.E, Brink, P.R, Ruwaard, D, Vrijhoef, H.J.M. (2014). Barriers to implementation of a redesign of information transfer and feedback in acute care: Results from a multiple case study. BMC Health Services Research 14 : 149. ScholarBank@NUS Repository.
Abstract: Accurate information transfer is an important element of continuity of care and patient safety. Despite the demonstrated urge for improvement of communication in acute care, there is a lack of data on improvements of communication. This study aims to describe the barriers to implementation of a redesign of the existing model for information transfer and feedback. Methods. A case study with six cases (i.e. acute care chains), using mixed methods was carried out in the Netherlands. The redesign was implemented in one acute care chain while the five other acute care chains served as control groups. Focus group interviews were held with members of the acute care chains and questionnaires were sent to care providers working in the acute care chains. Results: Respondents reported three sets of barriers for implementation of the model: (a) existing routines for information transfer and feedback in organizations within the acute care chain; (b) barriers related to the implementation method and time period; and (c) the absence of a high 'sense of urgency' amongst providers in the acute care chain which would aid in improving the communication process. Conclusions: This study shows that organizational factors play an important role in the success or failure of redesigning a communication process. Organizational routines can hamper implementation of a redesign if it differs too much from the routines of care providers involved. Besides focussing on provider characteristics in the implementation of a redesigned process, specific attention should be paid to unlearning existing organizational routines. © 2014 van Leijen-Zeelenberg et al.; licensee BioMed Central Ltd.
Source Title: BMC Health Services Research
ISSN: 14726963
DOI: 10.1186/1472-6963-14-149
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