The role of organizational structure in readiness for change: A conceptual integration

The purpose of this review is to extend extant conceptualizations of readiness for change as an individual-level phenomenon. This review-of-reviews focuses on existing conceptual frameworks from the dissemination, implementation, quality improvement, and organizational trasformation literatures in order to integrate theoretical rationales for how organization structure, a key dimension of the organizational context, may impact readiness for change. They propose that the organization structure dimensions of differentiation and integration impact readiness for change at the indicidual level of analysis by influencing four key concepts of relevance, legitimacy, preceived need for change, and resource allocation. 

Using Complexity and Network Concepts to Inform Healthcare Knowledge Translation

Many representations of the movement of healthcare knowledge through society exist, and multiple models for the translation of evidence into policy and practice have been articulated. Most are linear or cyclical and very few come dose to reflecting the dense and intricate relationships, systems and politicis of organizations and the processes required to enact sustainable improvements. This study illustrates how using complexity and network concepts can better inform knowledge translation (KT) and argue that changing the way we think and talk about KT could enhance the creation and movement of knowledge throughout those systems needing to develop and utilize it. 

The Core Dimensions of Integrated Care: A Literature Review to Support the Development of a Comprehensive Framework for Implementing Integrated Care

As part of the EU-funded Project INTEGRATE, the research sought to develop an evidence-based understanding of the key dimensions and items of integrated care associated with successful implementation across varying country contexts and relevant to different chronic and/or long-term conditions. This paper identifies the core dimensions of integrated care based on a review of previous literature on the topic

Improving Integrated Care: Can Implementation Science Unlock the ‘Black Box’ of Complexities?

In a previous IJIC editorial they reflected on the fact that we have yet to make any significant breakthrough to understand the implementation and sustainability of complex service innovations that so characterise the development of integrated care programmes [1]. Without such knowledge we might be able to explain the core building blocks of integrated care systems, but we cannot adequately explain the intricacies of effective implementation nor fully understand the causes of the outcomes we observe. This article show how this is not simply a methodological problem but reflects a more deep-rooted challenge in the lack of value that is placed both in the commissioning of such research and the findings that are produced.

Collaborative Governance for Integrated Care: Insights from a Policy Stakeholder Dialogue

Integrated care is a goal of many health care systems. However, operationalizing and implementing integrated care remains challenging especially in continuously evolving policy environments. We report on a policy symposium held in 2017 focused on operationalizing a particular integrated care policy in the context of policy evolution in Ontario, Canada.

A Contextual Analysis and Logic Model for Integrated Care for Frail Older Adults Living at Home: The INSPIRE Project

Implementation science methods and a theory-driven approach can enhance the understanding of whether, how, and why integrated care for frail older adults is successful in practice.

This study aimed to perform a contextual analysis, develop a logic model, and select preliminary implementation strategies for an integrated care model in newly created information and advice centers for older adults in Canton Basel-Landschaft, Switzerland.

The overall INSPIRE project aims to develop, implement and evaluate an integrated care model for the information and advice centers. This paper specifically addresses the development phase of INSPIRE and aims to:

• Determine the contextual factors which may influence the INSPIRE integrated care model for the IACs and implementation strategies by collecting information through various sources
• Develop a logic model to display the overall theory for the INSPIRE care model, including inputs, activities, outputs, anticipated outcomes and assumptions
• Propose preliminary implementation strategies for the INSPIRE care model

The innovation characteristics of person-centred care as perceived by healthcare professionals: an interview study employing a deductive-inductive content analysis guided by the consolidated framework for implementation research

Person-centred care (PCC) is promoted as an innovation that will improve patients’ rights and increase their participation in healthcare. Experience shows that the implementation of PCC is challenging and often results in varying levels of adoption. How health care professionals (HCPs) perceive an innovation such as PCC is an important factor to consider in implementation. 

Integrating case management for patients with complex needs in the ground practice: the importance of context in evaluative designs

Responding to complex needs calls for integrating care across providers, settings and sectors. Among models to improve integrated care, case management demonstrates a good evidence base of facilitating the appropriate delivery of healthcare services. Since case management is a complex, multi component intervention, with its component parts interacting in a non-linear manner, effectiveness is largely influenced by the context in which the intervention is implemented. This paper discusses how to respond to implementation challenges to evaluating complex interventions for patients with complex needs. Building on the example of case management, we suggest that documenting innovation effectiveness remains important, but that evaluation needs to include theory-based and systems perspectives. We also suggest that implementation science needs to be part of intervention design while engaging stakeholders to define the most relevant research questions and implementation effectiveness, to optimize successful implementation and sustainability.

Implementation Toolbox to Document and Analyze Primary Health Care Innovations

Implementation science is a multidisciplinary field that focuses on studying and promoting effective strategies for translating evidence-based interventions (EBIs) into routine practice to improve outcomes in real-world settings. It has been increasingly used to document and assess interventions, as it helps to make sense of how, when, where, and why research results and EBI are, or are not, being successfully used. When compared to traditional project design, implementation, and management of health care interventions, implementation science can add value by addressing the specific complexities and challenges associated with implementing and scaling up these interventions. More specifically, it helps to analyze and understand the contextual factors, stakeholder dynamics, and system-level barriers that can hinder the successful adoption and integration of health care interventions. In this sense, by integrating implementation science principles the World Bank can tailor strategies, develop robust implementation plans, and leverage evidence-based practices to overcome implementation problems, which is ...