Using the Functional Resonance Analysis Method to explore how elastic compression therapy is organised and could be...

Area of Science:

• Vascular Medicine
• Health Services Research
• Patient Care Processes

Background:

• Elastic compression stocking (ECS) therapy is a cornerstone treatment for deep venous thrombosis (DVT) and chronic venous insufficiency (CVI).
• Understanding the practical application and variability of ECS therapy is crucial for optimizing patient outcomes.
• A multi-stakeholder perspective is essential for identifying actionable improvements in healthcare delivery.

Purpose of the Study:

• To elucidate the structure and variability inherent in the elastic compression stocking (ECS) therapy process.
• To analyze the effects of ECS therapy on patient outcomes from a practical, real-world perspective.
• To identify key themes for improvement by engaging diverse stakeholders involved in ECS therapy.

Main Methods:

• Conducted 30 semi-structured interviews with healthcare professionals and patients involved in ECS therapy.
• Utilized the Functional Resonance Analysis Method (FRAM) to create work-as-done models of the ECS therapy process.
• Facilitated stakeholder meetings to discuss findings and identify improvement themes based on the FRAM models.

Main Results:

• Developed two FRAM models, one for each of the two Dutch regions studied, detailing functional variability and interdependencies.
• Identified six critical improvement themes: knowledge dissemination, optimizing initial compression therapy, supplier contact timing, assistive device implementation, harmonizing CVI follow-up, and personalizing DVT treatment duration.
• Highlighted the significant variability in ECS therapy performance and its impact on outcomes across different settings.

Conclusions:

• The study provides a granular understanding of elastic compression stocking (ECS) therapy as practiced daily, including its functional components and performance variations.
• Six actionable improvement themes were identified through a multi-stakeholder approach, offering a roadmap for enhancing ECS therapy delivery.
• This research emphasizes the need for standardized yet personalized approaches to ECS therapy for DVT and CVI patients.