
Improving Patient Care
The Implementation of Change in Clinical Practice
- 1st Edition - November 23, 2004
- Imprint: Butterworth-Heinemann
- Authors: Martin Eccles, Richard Grol, Michel Wensing
- Language: English
- Paperback ISBN:9 7 8 - 0 - 7 5 0 6 - 8 8 1 9 - 2
In the field of health care, a very large number of valuable insights, procedures and technologies become available each year. These come from well planned scientific research or… Read more

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Request a sales quoteIn the field of health care, a very large number of valuable insights, procedures and technologies become available each year. These come from well planned scientific research or careful experiments and evaluation in everyday practice. As many of these innovations are not adopted into daily practice, at the expense of improved patient care, it is crucial to understand how sucessful implementation can be achieved.
There are many reasons for this failure, such as the nature of the proposed method of working or simply that it is new; similarly, economic, structural or financial barriers may exist. Given the increasing significance and frequency of change in healthcare environments, the new research findings and hence insights into the implementation of change must be made available. This is the purpose of the book.
There are many reasons for this failure, such as the nature of the proposed method of working or simply that it is new; similarly, economic, structural or financial barriers may exist. Given the increasing significance and frequency of change in healthcare environments, the new research findings and hence insights into the implementation of change must be made available. This is the purpose of the book.
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.
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.
Care providers, staff involved in quality assessment, healthcare managers, policy makers and researchers who are concerned with the question of how best to design the implementation of valuable new and existing insights and procedures so that they contribute to optimal patient care.
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)
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)
- Edition: 1
- Published: November 23, 2004
- Imprint: Butterworth-Heinemann
- No. of pages: 296
- Language: English
- Paperback ISBN: 9780750688192
ME
Martin Eccles
Affiliations and expertise
William Leech Professor of Primary Care Research, Professor of Clinical Effectiveness (Personal Chair), School of Population and Health Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, UKRG
Richard Grol
Affiliations and expertise
Professor and Director, Centre for Quality of Care Research [WOK], Radboud University Nijmegen Medical Centre, Nijmegen, The NetherlandsMW
Michel Wensing
Affiliations and expertise
Senior Lecturer, Centre for Quality of Care Research (WOK), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands