Improving Patient Care

1st Edition

The Implementation of Change in Clinical Practice


  • Richard Grol
  • Michel Wensing
  • Martin Eccles
    • Print ISBN 9780750688192

    Key Features

    Aids the implementation of various changes including: the adoption of clinical guidelines; new procedures, technologies, care programmes and preventative programmes; care protocols, care pathways or processes that may lead to an improvement in patient care ['best practices']; removal of undesirable routines and variations in the care provided.
    All recommendations are based upon scientific evidence, careful evaluation or on good experience in practice - thus, on innovations that are firmly established as being able to contribute to better care for patients.
    Evidenced-based approach meets the need to learn from available evidence.
    Practical examples support readers who learn through experiences.
    Gives particular emphasis to implementation of clinical guidelines, one of the most important aids to achieving optimal care for patients.
    Demonstrates how any future implementation of clinical guidelines is an important part of their generation.
    Explains the importance of target group involvement in initial planning and delivery.
    Outlines helpful and unhelpful factors in the success of implementation of change and describes cost-effective strategies for overcoming them.
    Describes the role of firm organisation in planning and systems for evaluation.
    Takes the perspective of the implementer although includes discussion of the impact of change through the eyes of the target group.
    Translates principles and models to practice by providing action plans.
    Generalizable approach widens the book to all sectors of healthcare management.

    Table of Contents

    Introduction (Richard Grol)
    1. Implementation of changes in practice(Richard Grol)
    2. Theories on implementation of change in healthcare (Richard Grol, Marlies Hulscher, Michel Wensing, Martin Eccles)
    3. Effective implementation: a model (Richard Grol, Michel Wensing)
    4. Characteristics of successful innovations (Richard Grol, Michel Wensing)
    5. Clinical guidelines as a tool for implementing change in patient care (Jako Burgers, Richard Grol, Martin Eccles)
    6. Determinants of effective change (Michel Wensing, Richard Grol)
    7. Methods to identify implementation problems (Michel Wensing, Richard Grol)
    8. Selection of strategies (Richard Grol, Michel Wensing)
    9. Dissemination of innovations (Richard Grol, Michel Wensing)
    10. Educational interventions (Michel Wensing, Richard Grol)
    11. Feedback and reminders (Trudy van der Weijden, Richard Grol)
    12. Organisational and financial interventions (Michel Wensing, Niek Klazinga, Niek Klazinga, Richard Grol)
    13. Patient-mediated stategies (Michel Wensing, Glyn Elwyn, Richard Grol)
    14. Multifaceted interventions (Michel Wensing, Richard Grol)
    15. Effective organisation of the implementation(Richard Grol)
    16. Measuring changes in patient care: development and use of indicators (Joze Braspenning, Stephen Campbell, Richard Grol)
    17. Experimental evaluations of change and improvement strategies (Martin Eccles, Jeremy Grimshaw, Marion Campbell, Craig Ramsay)
    18. Observational evaluations of implementation strategies(Michel Wensing, Martin Eccles, Richard Grol)
    19. Process evaluation of change interventions (Marlies Hulscher, Miranda Laurant, Richard Grol)
    20. Economic evaluation of implementation strategies (Johan L Severens, Jody Martens and Michel Wensing)
    Epilogue (Richard Grol)


    No. of pages:
    © 2005
    Print ISBN: