Patient Needs and Resources

The extent to which patient needs, as well as barriers and facilitators to meet those needs, are accurately known and prioritized by the organization.

The extent to which patient needs, as well as barriers and facilitators to meet those needs, are accurately known and prioritized by the organization. Clearly, improving the health and well-being of patients is the mission of all healthcare entities, and many calls have gone out for organizations to be more patient-centered [1]. Patient-centered organizations are more likely to implement change effectively [2]. Many theories of research uptake or implementation acknowledge the importance of accounting for patient characteristics [3][4][5], and consideration of patients needs and resources must be integral to any implementation that seeks to improve patient outcomes [1]. The Practical, Robust Implementation and Sustainability Model PRISM delineates six elements that can help guide evaluation of the extent to which patients are at the center of organizational processes and decisions: patient choices are provided, patient barriers are addressed, transition between program elements is seamless, complexity and costs are minimized, and patients have high satisfaction with service and degree of access and receive feedback [3].

Many models and theories of research uptake or implementation do acknowledge the importance of accounting for patient characteristics [5] and assume that if they are not accounted for, implementation will be less effective [4][6].¬†The quality improvement literature has acknowledged that having a strong focus on the customer (patient) is an essential ‚Äúcore property‚ÄĚ for making progress in implementing quality improvement initiatives [1][7].¬†Organizations who use evidence-based practices more consistently relied on knowledge from nurses‚Äô experiences with patient interactions [8].¬†Effective implementation can be predicted, in part, by the extent to which organizations provide tools and advice that are matched to patients‚Äô readiness to change and when choices are presented to enhance patient activation and autonomy [3].¬†The extent to which an organization is successful in achieving this degree of ‚Äúpatient-centeredness‚ÄĚ can be determined by assessing factors in the inner setting e.g., related to Goals and Feedback (the extent to which goals and feedback are aligned with patient needs) and Compatibility (the extent to which an intervention targeted to help patients aligns with staff values and meaning attached to the intervention). Attention on patient satisfaction is consistently associated with greater perceived team effectiveness which in turn, influences the number and depth of changes implemented in an organization [2].

Inclusion Criteria

Include statements demonstrating (lack of) awareness of the needs and resources of those served by the organization. Analysts may be able to infer the level of awareness based on statements about:1. Perceived need for the innovation based on the needs of those served by the organization and if the innovation will meet those needs; 2. Barriers and facilitators of those served by the organization to participating in the innovation; 3. Participant feedback on the innovation, i.e. satisfaction and success in a program. In addition, include statements that capture whether or not awareness of the needs and resources of those served by the organization influenced the implementation or adaptation of the innovation.

Exclusion Criteria

Exclude statements that do or do not demonstrate a strong need for the innovation and/or that the current situation is untenable, e.g., statements that the innovation is absolutely necessary or that the innovation is redundant with other programs, and code to Tension for Change.

Exclude statements related to engagement strategies and outcomes, e.g., how innovation participants became engaged with the innovation, and code to Engaging: Innovation Participants.

Check out SIRC’s Instrument Review project and published systematic review protocol, which has cataloged over 400 implementation-related measures. 

Note: As we become aware of measures, we will post them here. Please contact us with updates.

  1. Institute of Medicine: Crossing the Quality Chasm: A New Health System for the 21st Century Washington, DC: National Academy Press; 2001.
  2. Shortell SM, Marsteller JA, Lin M, Pearson ML, Wu SY, Mendel P, Cretin S, Rosen M: The role of perceived team effectiveness in improving chronic illness care. Med Care 2004, 42:1040-1048.
  3. Feldstein AC, Glasgow RE: A practical, robust implementation and sustainability model (PRISM) for integrating research findings into practice. Joint Commission journal on quality and patient safety/Joint Commission Resources 2008, 34:228-243.
  4. Rycroft-Malone JA, Kitson G, Harvey B, McCormack K, Seers AT, Estabrooks C: Ingredients for change: revisiting a conceptual framework. (Viewpoint). Quality and Safety in Health Care2002, 11:174-180.
  5. Graham ID, Logan J: Innovations in knowledge transfer and continuity of care. Can J Nurs Res 2004, 36:89-103.
  6. Kitson A, Harvey G, McCormack B: Enabling the implementation of evidence based practice: a conceptual framework. Qual Health Care 1998, 7:149-158.
  7. Ferlie EB, Shortell SM: Improving the quality of health care in the United Kingdom and the United States: a framework for change. Milbank Q 2001, 79:281-315.
  8. Squires JE, Moralejo D, Lefort SM: Exploring the role of organizational policies and procedures in promoting research utilization in registered nurses. Implement Sci 2007, 2:17.