8. Determinants of change

  1. Richard Grol,
  2. Michel Wensing,
  3. Martin Eccles and
  4. David Davis
  1. Michel Wensing1,
  2. Marije Bosch2 and
  3. Richard Grol1

Published Online: 28 JUN 2013

DOI: 10.1002/9781118525975.ch8

Improving Patient Care: The Implementation of Change in Health Care, Second Edition

Improving Patient Care: The Implementation of Change in Health Care, Second Edition

How to Cite

Wensing, M., Bosch, M. and Grol, R. (2013) Determinants of change, in Improving Patient Care: The Implementation of Change in Health Care, Second Edition (eds R. Grol, M. Wensing, M. Eccles and D. Davis), John Wiley & Sons, Ltd, Oxford, UK. doi: 10.1002/9781118525975.ch8

Author Information

  1. 1

    Department IQ healthcare, UMC St Radboud, Nijmegen, the Netherlands

  2. 2

    National Trauma Research Institute/Central Clinical School, Monash University, Melbourne, Victoria, Australia

Publication History

  1. Published Online: 28 JUN 2013
  2. Published Print: 20 MAY 2013

ISBN Information

Print ISBN: 9780470673386

Online ISBN: 9781118525975

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Keywords:

  • determinants;
  • healthcare changes;
  • healthcare practice;
  • stakeholders

Summary

A wide range of factors can influence the process of the implementation of innovations in healthcare practice. These factors are related to the innovation that is implemented, the individuals who are expected to adopt it, the social setting in which they act, the healthcare organization, and health systems. The “determinants of change” can strengthen or weaken the impact of implementation strategies. This chapter describes factors to be considered in a diagnostic analysis preceding a program for improving healthcare. A diagnostic analysis of determinants of implementation is an important component of planned implementation programs. A comprehensive diagnostic analysis comprises an analysis of stakeholders, identification of determinants related to specific goals for improvement, and identification of relevant subgroups among adopters of the innovation. Research evidence supporting the actual impact of specific determinants on process of implementation is limited. This chapter focuses on the impact of team processes on the uptake of innovations.