Email updates

Keep up to date with the latest news and content from BMC Health Services Research and BioMed Central.

Open Access Research article

Barriers to implementation of a redesign of information transfer and feedback in acute care: results from a multiple case study

Janneke E van Leijen-Zeelenberg1*, Arno JA van Raak1, Inge GP Duimel-Peeters23, Mariëlle EAL Kroese12, Peter RG Brink4, Dirk Ruwaard1 and Hubertus JM Vrijhoef56

Author Affiliations

1 Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands

2 Department of Patient and Care, Maastricht University Medical Center, Maastricht, The Netherlands

3 Department of General Practice, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands

4 Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands

5 Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore

6 Scientific Center of Care and Welfare (Tranzo), Tilburg University, Tilburg, The Netherlands

For all author emails, please log on.

BMC Health Services Research 2014, 14:149  doi:10.1186/1472-6963-14-149

Published: 3 April 2014

Abstract

Background

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.

Keywords:
Communication; Redesign; Barriers; Implementation; Acute care; Emergency care; Healthcare providers