Framework for Research on Implementation of Process Redesigns

Area of Science:

• Healthcare Management
• Implementation Science
• Process Improvement

Background:

• Complex system interventions require careful consideration of implementation factors and outcomes.
• Process redesign (PR) is a critical strategy in healthcare improvement.
• Understanding factors influencing PR success is essential for effective healthcare delivery.

Purpose of the Study:

• To describe a framework for examining factors affecting process redesign (PR) in healthcare.
• To assess the outcomes of PR initiatives.
• To provide a structured approach for evaluating PR implementation.

Main Methods:

• Development of the PR framework based on the Consolidated Framework for Implementation Research (CFIR).
• Literature scans and expert consultation informed framework development.
• Application of the PR framework as a case study to Lean-based primary care redesigns.

Main Results:

• The PR framework expands the CFIR with domains for implementation and outcomes measurement.
• External factors like healthcare reform influenced the perceived need for redesign.
• Physician concerns included colocation, workflow management, and staff competencies.
• Team acceptance of redesign was affected by implementation processes and clinic-specific contextual features.

Conclusions:

• The PR framework effectively guided a qualitative study on primary care redesign.
• The framework assisted researchers in identifying critical issues impacting PR implementation.
• The PR framework provides valuable insights for leadership regarding healthcare intervention success.