Explaining variation of implementation outcomes of centralized waiting lists for unattached patients: A comparative multiple case study in Quebec
Date
2019
Authors
Abou Malham, Sabina
Smithman, Mélanie Ann
Touati, Nassera
Brousselle, Astrid
Loignon, Christine
Dubois, Carl-Ardy
Nour, Kareen
Boivin, Antoine
Breton, Mylaine
Journal Title
Journal ISSN
Volume Title
Publisher
Journal of Health Organization and Management
Abstract
Purpose:
Centralized waiting lists (CWLs) for patient attachment to a primary care provider have been implemented across Canada, including Quebec. Little is known about the implementation of CWLs and the factors that influence implementation outcomes of such primary care innovations. The purpose of this paper is to explain variations in the outcomes of implementation by analyzing the characteristics of CWLs and contextual factors that influence their implementation.
Design/methodology/approach:
A multiple qualitative case study was conducted. Four contrasting CWLs were purposefully selected: two relatively high-performing and two relatively low-performing cases with regard to process indicators. Data collected between 2015 and 2016 drew on three sources: 26 semi-structured interviews with key stakeholders, 22 documents and field notes. The Consolidated Framework for Implementation Research was used to identify, through a cross-case comparison of ratings, constructs that distinguish high from low-performing cases.
Findings:
Five constructs distinguished high from low-performing cases: three related to the inner setting: network and communications; leadership engagement; available resources; one from innovation characteristics: adaptability with regard to registration, evaluation of priority and attachment to a family physician; and, one associated with process domain: engaging. Other constructs exerted influence on implementation (e.g. outer setting, individual characteristics), but did not distinguish high and low-performing cases.
Originality/value:
This is the first in-depth analysis of CWL implementation. Results suggest important factors that might be useful in efforts to continuously improve implementation performance of CWLs and similar innovations.
Description
Keywords
Primary healthcare, Waiting lists, Implementation effectiveness, Family practice, Case study
Citation
Abou Malham, S., Smithman, M., Touati, N., Brousselle, A., Loignon, C., Dubois, C., … Breton, M. (2019). Explaining variation of implementation outcomes of centralized waiting lists for unattached patients: A comparative multiple case study in Quebec. Journal of Health Organization and Management, 33(5), 563-587. https://doi.org/10.1108/JHOM-10-2018-0303.