Nationwide implementation of ACTion: Audit generated changes in perinatal care using “Tailored” implementation strategies
Projectomschrijving
Landelijke implementatie van ACTion
Vraagstuk
Dit project gaat 18 Verloskundig Samenwerkingsverbanden (VSV’s) uit het hele land ondersteunen bij het invoeren van verbeteringen die voortkomen uit perinatale audits. De methodiek heeft zich in Noord-Nederland bewezen en wordt verder uitgerold.
Onderzoek en verwachte uitkomst
De interventie bestaat uit een training voor de supervisoren van de 8 regio's. Zij zullen VSV’s in hun regio instrueren in de ACTion-methode (E-learning, trainingen en follow-up-sessies).
Het VSV-ACTionteam volgt een training. Deze training behelst het formuleren van actiepunten, het ontwerpen van passende implementatiestrategieën en het implementeren van de verbeteringen in het VSV. Een eerder ontwikkelde toolkit wordt een belangrijk instrument. Zie http://www.actiontoolkit.nl
De studie is een stepped wedge-trial. De deelnemende VSV’s beginnen met een nulmeting en gaan getrapt starten met de ACTionteams.
Verslagen
Samenvatting van de aanvraag
BACKGROUND: The recent ACTion-project has demonstrated that implementation of the ACTion-instrument facilitates implementing perinatal care improvements in Perinatal Cooperation Units (PCUs) in the North of the Netherlands. Extending the ACTion-methodology to the other regions seems logical. However, there is considerable regional variation both in maternal / obstetric and organisational characteristics. Our aim is to study the influence of these obstetric and organisational characteristics of the PCUs on the implementation process. INTERVENTION: Implementation of the ACTion-methodology in 18 PCUs in all regions of the Netherlands, except the Northern part (where the ACTion-methodology is already implemented) AIM: 1. To evaluate the implementation of the ACTion-methodology in all selected PCUs. The ACTion-methodology consists of a basic training and of follow-up sessions in which problems regarding implementation are discussed. 2. To evaluate whether (regional and local) variation in population, organisation and management of PCUs influence (a) the level of implementation of improvements and (b) the prioritisation of improvement suggestions eligible for implementation according to the ACTion methodology. 3. To gain further knowledge about important success- and failure factors for implementation within a PCU, such as level of collaboration or specific regional characteristics. PRIMARY OUTCOME: The level of implementation of suggestions for perinatal care improvement. Analyses by region and by level of perinatal collaboration. SECONDARY OUTCOME: Process evaluation, knowledge and experiences of care providers and ACTion team members – including patient representatives and perinatal mortalality. DESIGN: Stepped-wedge design. All 18 PCUs will start as a control group and will implement audit generated changes as usual. With intervals of 4 months, 6 practices will change status from control to intervention group and will start training. GEOGRAPHICAL SETTING: 18 PCUs in all regions of the Netherlands, except the Northern part. STUDY DURATION: 4 years. PROJECT GROUP: The project group is multidisciplinary The study will be performed in cooperation with the Obstetric Consortium of Groningen, the audit teams of all regions and Perined. Patients will be involved at different levels in the study, representation will come from the ‘Patientenfederatie’ and from local Client Counsels.