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Diffusion of a collaborative care model in primary care: a longitudinal qualitative study.
Isabelle Vedel1, Veronique Ghadi, Matthieu De Stampa
1Solidage, McGill University - Université de Montréal Research Group on Frailty and Aging - Lady Davis Institute, Jewish General Hospital, Côte Ste Catherine, Montreal, Québec, Canada. isabelle.vedel@mcgill.ca
BMC Family Practice
|January 8, 2013
Summary
Collaborative team models (CTM) adoption by primary care clinicians (PCPs) was influenced by perceived compatibility and advantage. Opinion leaders and reaching a critical mass of adopters are key to accelerating CTM implementation.
Area of Science:
- Healthcare Management
- Health Services Research
- Diffusion of Innovations
Background:
- Collaborative team models (CTM) enhance care processes and outcomes but face adoption challenges among primary care clinicians (PCPs).
- Understanding the factors influencing CTM adoption and diffusion is crucial for effective implementation strategies.
Purpose of the Study:
- To investigate how perceived characteristics of CTMs influenced PCPs' adoption decisions.
- To analyze the diffusion process of CTMs within primary care settings.
Main Methods:
- A longitudinal case study employing the Diffusion of Innovations Theory.
- Development of diffusion curves for 175 PCPs and 59 nurses.
- Semi-structured interviews with 40 PCPs and 15 nurses to explore implementation dynamics.
Main Results:
- Within 3.5 years, 100% of nurses and over 80% of PCPs adopted the CTM.
- Nurses adopted the CTM faster than PCPs, reaching critical mass earlier.
- Perceived compatibility and relative advantage significantly influenced adoption dynamics, with opinion leaders playing a key role among PCPs.
Conclusions:
- CTM diffusion is a social process requiring clinician commitment and risk-taking, with opinion leaders being pivotal.
- Implementation strategies should focus on achieving a critical mass of adopters to accelerate CTM uptake by clinicians.
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