English conference proceeding
Theunissen, N. C. M. (2004).
Telling people how to change health care is not enough! Testing the
model for Implementation of Change in Health Care. Paper accepted
for presentation at the Fifth Conference on Psychology and Health, May 10-12,
2004, Rolduc Conference Center, Kerkrade, the Netherlands.
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Abstract
For years now, health psychology has successfully unravelled many factors that could improve health care. However, according to the literature this knowledge is seldom brought into practice. The implementation of a new health care model requires permanent behaviour changes in caregivers, but it seems that telling people how to change their behaviour is not enough. Instead a systematic approach is needed. The current study presents such a systematic approach by means of the model for Implementation of Change in Health Care (ICHC-model).The ICHC-model comprises of three phases in the monitoring of an implementation project. The planning phase evaluates in what amount the project plans include activities recommended by implementation literature. This implies, for instance, that target groups and organizational characteristics are taken into consideration (e.g. knowledge, skills, habits, motivation, organizational structure and culture). The process phase monitors the interventions that have actually been performed. It checks for instance, if target groups are involved as planned. The outcome phase evaluates the results at three levels: (1) the consolidation of the implemented procedure or product; (2) the achieved changes in the health care process; and (3) the achieved effects on quality of care and health. It was hypothesized that the better project plans meet implementation recommendations, the better their results, provided that interventions have actually been performed.
The ICHC-model was tested using files of 77 implementation projects that were completed between 1997-2001 under administration of the Netherlands Organisation for Health Research and Development (ZonMw). The three phases of the ICHC-model were translated into three checklists. Multiple correlations and regression analyses showed that the hypothesis could be supported for the most part.
If one would like to change health care practise, than a step-by-step implementation planning with a clear goal is necessary, along with the budget to perform it. Furthermore, the target group (doctors, patients) need to be involved and characteristics of both target group and organization need to be taken into consideration. Using the model for Implementation of Change in Health Care will enlarge the possibility that health psychology findings will positively change health care practice.
