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
SN - 1472-6963
VL - 17
SP - 331
JO - BMC Health Services Research
JF - BMC Health Services Research
IS - 1
ER -