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The complexity in the implementation process of empowerment-based chronic kidney care: a case study
Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
Linneus University, Växjö SE- 351 95, Sweden.
Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 187, Lund SE-221 00, Sweden.
2014 (English)In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 13, no 22, 1-10 p.Article in journal (Refereed) Published
Abstract [en]

Background: This study is part of an interactive improvement intervention aimed to facilitate empowerment-based chronic kidney care using data from persons with CKD and their family members. There are many challenges to implementing empowerment-based care, and it is therefore necessary to study the implementation process. The aim of this study was to generate knowledge regarding the implementation process of an improvement intervention of empowerment for those who require chronic kidney care.

Methods: A prospective single qualitative case study was chosen to follow the process of the implementation over a two year period. Twelve health care professionals were selected based on their various role(s) in the implementation of the improvement intervention. Data collection comprised of digitally recorded project group meetings, field notes of the meetings, and individual interviews before and after the improvement project. These multiple data were analyzed using qualitative latent content analysis.

Results: Two facilitator themes emerged: Moving spirit and Encouragement. The healthcare professionals described a willingness to individualize care and to increase their professional development in the field of chronic kidney care. The implementation process was strongly reinforced by both the researchers working interactively with the staff, and the project group. One theme emerged as a barrier: the Limitations of the organization. Changes in the organization hindered the implementation of the intervention throughout the study period, and the lack of interplay in the organization most impeded the process.

Conclusions: The findings indicated the complexity of maintaining a sustainable and lasting implementation over a period of two years. Implementing empowerment-based care was found to be facilitated by the cooperation between all involved healthcare professionals. Furthermore, long-term improvement interventions need strong encouragement from all levels of the organization to maintain engagement, even when it is initiated by the health care professionals themselves.

Place, publisher, year, edition, pages
2014. Vol. 13, no 22, 1-10 p.
Keyword [en]
Case study, Empowerment, Healthcare professionals, Implementation process, Improvement intervention
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hj:diva-25395DOI: 10.1186/1472-6955-13-22PubMedID: 25104917Scopus ID: 2-s2.0-84905922592OAI: oai:DiVA.org:hj-25395DiVA: diva2:773472
Available from: 2014-12-19 Created: 2014-12-19 Last updated: 2017-12-05Bibliographically approved

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