Key aspects related to implementation of risk stratification in health care systems-the ASSEHS study

Joana Mora, Miren David Iturralde, Lucía Prieto, Cristina Domingo, Marie-Pierre Gagnon, Catalina Martínez-Carazo, Anna Giné March, Daniele De Massari, Tino Martí, Marco Nalin, Francesca Avolio, Jean Bousquet, Esteban de Manuel Keenoy, all ASSEHS group

Research output: Contribution to journalReview articleScientificpeer-review

Abstract

BACKGROUND: The lack of proven efficacy of new healthcare interventions represents a problem for health systems globally. It is partly related to suboptimal implementation processes, leading to poor adoption of new interventions. Activation of Stratification Strategies and Results of the interventions on frail patients of Healthcare Services (ASSEHS) EU project (N° 2013 12 04) aims to study current existing health Risk Stratification (RS) strategies and tools on frail elderly patients. This paper aims at identifying variables that make the implementation of population RS tools feasible in different healthcare services.

METHODS: Two different methods have been used to identify the key elements in stratification implementation; i) a Scoping Review, in order to search and gather scientific evidence and ii) Semi-structured interviews with six key experts that had been actively involved in the design and/or implementation of RS strategies. It aims to focus the implementation construct on real-life contextual understandings, multi-level perspectives, and cultural influences.

RESULTS: A Feasibility Framework has been drawn. Two dimensions impact the feasibility of RS: (i) Planning, deployment and change management and (ii) Care intervention. The former comprises communication, training and mutual learning, multidisciplinarity of the team, clinicians' engagement, operational plan and ICT display and functionalities. The latter includes case finding and selection of the target population, pathway definition and quality improvement process.

CONCLUSIONS: The Feasibility Framework provides a list of key elements that should be considered for an effective implementation of population risk stratification interventions. It helps to identify, plan and consider relevant elements to ensure a proper RS implementation.

Original languageEnglish
Pages (from-to)331
JournalBMC Health Services Research
Volume17
Issue number1
DOIs
Publication statusPublished - 2017
Externally publishedYes

Fingerprint

Delivery of Health Care
Frail Elderly
Communication
Interviews

Keywords

  • Aged
  • Delivery of Health Care
  • Feasibility Studies
  • Frail Elderly
  • Health Services
  • Health Services Research
  • Humans
  • Quality Improvement
  • Risk Assessment
  • Journal Article
  • Review

Cite this

Mora, J., Iturralde, M. D., Prieto, L., Domingo, C., Gagnon, M-P., Martínez-Carazo, C., ... all ASSEHS group (2017). Key aspects related to implementation of risk stratification in health care systems-the ASSEHS study. BMC Health Services Research, 17(1), 331. https://doi.org/10.1186/s12913-017-2275-3
Mora, Joana ; Iturralde, Miren David ; Prieto, Lucía ; Domingo, Cristina ; Gagnon, Marie-Pierre ; Martínez-Carazo, Catalina ; March, Anna Giné ; De Massari, Daniele ; Martí, Tino ; Nalin, Marco ; Avolio, Francesca ; Bousquet, Jean ; Keenoy, Esteban de Manuel ; all ASSEHS group. / Key aspects related to implementation of risk stratification in health care systems-the ASSEHS study. In: BMC Health Services Research. 2017 ; Vol. 17, No. 1. pp. 331.
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Mora, J, Iturralde, MD, Prieto, L, Domingo, C, Gagnon, M-P, Martínez-Carazo, C, March, AG, De Massari, D, Martí, T, Nalin, M, Avolio, F, Bousquet, J, Keenoy, EDM & all ASSEHS group 2017, 'Key aspects related to implementation of risk stratification in health care systems-the ASSEHS study', BMC Health Services Research, vol. 17, no. 1, pp. 331. https://doi.org/10.1186/s12913-017-2275-3

Key aspects related to implementation of risk stratification in health care systems-the ASSEHS study. / Mora, Joana; Iturralde, Miren David; Prieto, Lucía; Domingo, Cristina; Gagnon, Marie-Pierre; Martínez-Carazo, Catalina; March, Anna Giné; De Massari, Daniele; Martí, Tino; Nalin, Marco; Avolio, Francesca; Bousquet, Jean; Keenoy, Esteban de Manuel; all ASSEHS group.

In: BMC Health Services Research, Vol. 17, No. 1, 2017, p. 331.

Research output: Contribution to journalReview articleScientificpeer-review

TY - JOUR

T1 - Key aspects related to implementation of risk stratification in health care systems-the ASSEHS study

AU - Mora, Joana

AU - Iturralde, Miren David

AU - Prieto, Lucía

AU - Domingo, Cristina

AU - Gagnon, Marie-Pierre

AU - Martínez-Carazo, Catalina

AU - March, Anna Giné

AU - De Massari, Daniele

AU - Martí, Tino

AU - Nalin, Marco

AU - Avolio, Francesca

AU - Bousquet, Jean

AU - Keenoy, Esteban de Manuel

AU - all ASSEHS group

PY - 2017

Y1 - 2017

N2 - BACKGROUND: The lack of proven efficacy of new healthcare interventions represents a problem for health systems globally. It is partly related to suboptimal implementation processes, leading to poor adoption of new interventions. Activation of Stratification Strategies and Results of the interventions on frail patients of Healthcare Services (ASSEHS) EU project (N° 2013 12 04) aims to study current existing health Risk Stratification (RS) strategies and tools on frail elderly patients. This paper aims at identifying variables that make the implementation of population RS tools feasible in different healthcare services.METHODS: Two different methods have been used to identify the key elements in stratification implementation; i) a Scoping Review, in order to search and gather scientific evidence and ii) Semi-structured interviews with six key experts that had been actively involved in the design and/or implementation of RS strategies. It aims to focus the implementation construct on real-life contextual understandings, multi-level perspectives, and cultural influences.RESULTS: A Feasibility Framework has been drawn. Two dimensions impact the feasibility of RS: (i) Planning, deployment and change management and (ii) Care intervention. The former comprises communication, training and mutual learning, multidisciplinarity of the team, clinicians' engagement, operational plan and ICT display and functionalities. The latter includes case finding and selection of the target population, pathway definition and quality improvement process.CONCLUSIONS: The Feasibility Framework provides a list of key elements that should be considered for an effective implementation of population risk stratification interventions. It helps to identify, plan and consider relevant elements to ensure a proper RS implementation.

AB - BACKGROUND: The lack of proven efficacy of new healthcare interventions represents a problem for health systems globally. It is partly related to suboptimal implementation processes, leading to poor adoption of new interventions. Activation of Stratification Strategies and Results of the interventions on frail patients of Healthcare Services (ASSEHS) EU project (N° 2013 12 04) aims to study current existing health Risk Stratification (RS) strategies and tools on frail elderly patients. This paper aims at identifying variables that make the implementation of population RS tools feasible in different healthcare services.METHODS: Two different methods have been used to identify the key elements in stratification implementation; i) a Scoping Review, in order to search and gather scientific evidence and ii) Semi-structured interviews with six key experts that had been actively involved in the design and/or implementation of RS strategies. It aims to focus the implementation construct on real-life contextual understandings, multi-level perspectives, and cultural influences.RESULTS: A Feasibility Framework has been drawn. Two dimensions impact the feasibility of RS: (i) Planning, deployment and change management and (ii) Care intervention. The former comprises communication, training and mutual learning, multidisciplinarity of the team, clinicians' engagement, operational plan and ICT display and functionalities. The latter includes case finding and selection of the target population, pathway definition and quality improvement process.CONCLUSIONS: The Feasibility Framework provides a list of key elements that should be considered for an effective implementation of population risk stratification interventions. It helps to identify, plan and consider relevant elements to ensure a proper RS implementation.

KW - Aged

KW - Delivery of Health Care

KW - Feasibility Studies

KW - Frail Elderly

KW - Health Services

KW - Health Services Research

KW - Humans

KW - Quality Improvement

KW - Risk Assessment

KW - Journal Article

KW - Review

U2 - 10.1186/s12913-017-2275-3

DO - 10.1186/s12913-017-2275-3

M3 - Review article

C2 - 28476126

VL - 17

SP - 331

JO - BMC Health Services Research

JF - BMC Health Services Research

SN - 1472-6963

IS - 1

ER -