Abstract
BackgroundBridging the knowledge-to-practice gap in health care is an important issue that has gained interest in recent years. Implementing new methods, guidelines or tools into routine care, however, is a slow and unpredictable process, and the factors that play a role in the change process are not yet fully understood. There is a number of theories concerned with factors predicting successful implementation in various settings, however, this issue is insufficiently studied in primary health care (PHC). The objective of this article was to apply implementation theory to identify key factors influencing the adoption of an innovation being introduced in PHC in Sweden.MethodsA qualitative study was carried out with staff at six PHC units in Sweden where a computer-based test for lifestyle intervention had been implemented. Two different implementation strategies, implicit or explicit, were used. Sixteen focus group interviews and two individual interviews were performed. In the analysis a theoretical framework based on studies of implementation in health service organizations, was applied to identify key factors influencing adoption.ResultsThe theoretical framework proved to be relevant for studies in PHC. Adoption was positively influenced by positive expectations at the unit, perceptions of the innovation being compatible with existing routines and perceived advantages. An explicit implementation strategy and positive opinions on change and innovation were also associated with adoption. Organizational changes and staff shortages coinciding with implementation seemed to be obstacles for the adoption process.ConclusionWhen implementation theory obtained from studies in other areas was applied in PHC it proved to be relevant for this particular setting. Based on our results, factors to be taken into account in the planning of the implementation of a new tool in PHC should include assessment of staff expectations, assessment of the perceived need for the innovation to be implemented, and of its potential compatibility with existing routines. Regarding context, we suggest that implementation concurrent with other major organizational changes should be avoided. The choice of implementation strategy should be given thorough consideration.
Highlights
Bridging the knowledge-to-practice gap in health care is an important issue that has gained interest in recent years
The objective of this article was to apply implementation theory to identify key factors influencing the adoption of an innovation being introduced in primary health care (PHC) in Sweden
The four themes suggested in the theoretical framework did serve to cover all the experiences expressed by staff at the PHC units, which shows that the framework is suitable for evaluation of implementation in PHC
Summary
Bridging the knowledge-to-practice gap in health care is an important issue that has gained interest in recent years. Improvement in quality of health care has gained interest among policy makers in recent years, and bridging the knowledge-to-practice gap is a major concern in many countries. Implementing new methods, guidelines or tools into routine care, is a slow and unpredictable process [1], and the factors that play a role in. The diffusion of innovations in health service organisations was studied by Greenhalgh et al [6] in a systematic literature review. They found that the attributes of the innovation, adopter characteristics, contextual factors (inner and outer context) and dissemination efforts are important factors. A study of the implementation of a new care policy in Swedish health care revealed a more positive view among hospital staff than among PHC staff, and obstacles caused by a frustrating situation were more common in PHC [10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
