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Cited by 272Health Policy Implementation ScienceHealthcare Quality and ManagementInnovations in Medical Education

Tailoring quality improvement interventions to identified barriers: a multiple case analysis

Bosch, Marije, Van Der Weijden, Trudy, Wensing, Michel, Grol, Richard·2007·Journal of Evaluation in Clinical Practice
DOI 10.1111/j.1365-2753.2006.00660.x
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Abstract

Rationale, aims and objectives The prevailing view on implementation interventions to improve the organization and management of health care is that the interventions should be tailored to potential barriers. Ideally, possible barriers are analysed before the quality improvement interventions are developed to influence both type and content of the implementation intervention. While tailoring educational improvement interventions generally requires the assessment of professional knowledge and skills, less is known about methods to tailor organizational interventions. In the present study, the results of previous studies on the development of educational and organizational interventions to improve the quality of health care are examined. Method Qualitative analyses were conducted on a purposeful sample of 20 quality improvement studies reporting barrier analyses and covering both educational and organizational interventions. Results Several methods were used to identify barriers, including focus group discussions, face‐to‐face interviews and telephone interviews. Attention to barriers prior to the development of the intervention did not always mean that the choice of a specific type of intervention was based on such, although identified barriers were often used to adjust the specific content of the intervention. A few methods to link improvement interventions to identified barriers were described, including theory‐based reasoning and iterative design processes. Results suggest there is often a mismatch between the level of identified barriers and the type of interventions selected for use. No differences in the tailoring of educational or organizational interventions could be identified. Conclusions The design of quality improvement interventions appears to still be in its infancy. The translation of identified barriers into tailor‐made implementation interventions is still a black box for both educational and organizational interventions.

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Crossref · 10.1111/j.1365-2753.2006.00660.x

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  • The selection of implementation strategies may be justified by prospective assessments that identify potential needs, barriers, or facilitators, sometimes termed determinants of practice.

    “The selection of implementation strategies may be justified by prospective assessments that identify potential needs, barriers, or facilitators—sometimes termed ‘determinants of practice’ [43,55,85,86].”

    From Implementation strategies: recommendations for specifying and reporting (2013) · cites this paper as [85]

  • A review of 20 studies found that implementation strategies were often poorly conceived, with mismatches between strategies and determinants.

    “as evidenced by a review of 20 studies that found that implementation strategies were often poorly conceived, with mismatches between strategies and determinants (e.g., barriers were identified at the team or organizational level, but strategies were not focused on structures and processes at those levels) (42).”

    From Enhancing the Impact of Implementation Strategies in Healthcare: A Research Agenda (2019) · cites this paper as [42]

  • Strategies are not always well-matched to the contexts in which they are deployed, including the interventions to be implemented, settings, stakeholder preferences, and implementation determinants.

    “Consequently, strategies are not always well-matched to the contexts in which they are deployed, including the interventions to be implemented, settings, stakeholder preferences, and implementation determinants (37, 42, 54).”

    From Enhancing the Impact of Implementation Strategies in Healthcare: A Research Agenda (2019) · cites this paper as [42]

  • Bosch and colleagues undertook a qualitative analysis of 20 quality improvement studies reporting investigation of determinants.

    “Bosch and colleagues undertook a qualitative analysis of 20 quality improvement studies reporting investigation of determinants (Bosch 2007).”

    From Tailored interventions to address determinants of practice (2015) · cites this paper as Bosch 2007

  • In many studies, the reasons for believing a particular strategy would address a particular determinant were not explained.

    “but in many studies the reasons for believing a particular strategy would address a particular determinant were not explained.”

    From Tailored interventions to address determinants of practice (2015) · cites this paper as Bosch 2007

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Authors
Bosch, M., Van Der Weijden, T., Wensing, M., & Grol, R.
Affiliations
Radboud University Medical Center (NL)
Corresponding author
Bosch, Marije
ORCID
Venue
Journal of Evaluation in Clinical Practice
Publisher
Wiley
Published
2006-12-12
Volume
13
Issue
2
Pages
161-168
ISSN
  • 1356-1294 (ISSN-L)
  • 1365-2753
DOI
10.1111/j.1365-2753.2006.00660.x
OpenAlex
W2108156946
Cited by
272
References
40
Citations by year
2026: 4 · 2025: 6 · 2024: 9 · 2023: 11 · 2022: 18 · 2021: 20 · 2020: 28 · 2019: 8 · 2018: 8 · 2017: 13 · 2016: 5 · 2015: 16 · 2014: 21 · 2013: 22 · 2012: 13
FWCI
2.60
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of Evaluation in Clinical Practice (publishedVersion)
  • PubMed (publishedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Health Professions › Health Information Management › Healthcare Quality and Management
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
Keywords
quality improvement intervention, implementation barriers, intervention tailoring, organizational interventions, educational intervention, quality of care, barrier analysis, iterative design, health management
MeSH terms
Netherlands, Quality Assurance, Health Care, Program Development, Organizational Case Studies

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