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Implementing a care pathway for elderly patients, a comparative qualitative process evaluation in primary care
Tove Røsstad1,2, Helge Garåsen3,4, Aslak Steinsbekk5
1Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. tove.rosstad@ntnu.no.
BMC Health Services Research
|April 19, 2015
Summary
Implementing a new care pathway for elderly patients in Norway proved challenging. Successful integration required strong management support and sustained effort, with only two of six municipalities fully adopting the pathway.
Area of Science:
- Health Services Research
- Implementation Science
- Geriatric Care
Background:
- A generic care pathway was developed in Central Norway to improve care for elderly patients discharged from hospital needing home care.
- The pathway aimed to enhance collaboration between general hospitals and primary care services.
Purpose of the Study:
- To investigate the implementation process of the care pathway.
- To compare the experiences of healthcare professionals and managers in home care services across participating municipalities.
Main Methods:
- A qualitative comparative process evaluation was conducted.
- Data were gathered through individual and focus group interviews.
- The Normalization Process Theory was applied to analyze the integration of the care pathway into practice.
Main Results:
- Expectations for improved care coordination and follow-up were high, but staff training was essential.
- Key success factors included executive management involvement, managerial focus on engagement, practical facilitation, and organizational stability.
- The care pathway was fully integrated in two of six municipalities, demonstrating potential for structuring services and improving collaboration.
Conclusions:
- The care pathway shows potential for enhancing primary care follow-up for elderly patients, improving quality and efficiency.
- Implementing this complex intervention demanded significant, sustained effort across all organizational levels.
- Long-term follow-up studies are crucial to assess the integration of such complex interventions into routine practice.
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