Table 4 Illustrative quotes of participants
Outcomes of the implementation process | “I have one patient who actually ended up with a ZWIP…and I never hear anything from him” General practitioner1 |
“But I think that everyone who participates in the ZWIP here in the municipality…they have asked me to become involved in their network….so it’s tens of people” Other professional1 | |
“Whereas this week I saw, with another man here in X, he communicates [over the ZWIP] with the general practitioner by himself” Professional conducting the screening1 | |
Appreciation of the implementation strategies | “But those other disciplines, you never or rarely talk to them, and in those three [educational] meetings that we had here it was very interesting to see that, yes, what everyone does, yes, what the added value is of everyone…so you put people in primary care, also due to this project, around the table” Other professional1 |
“Yes, it [the educational program] helped, but then it was too lengthy to send all eight general practitioners there” General practitioner2 | |
“Yes, I really felt [coaching] was very important, for example, starting up a ZWIP account for the first time…just to accompany her one time and to see, and how it is done, yes, that just works better than a paper manual” Professional conducting the screening1 | |
Barriers and facilitators to the ZWIP | “Or older people that say like, yes, I need to call the general practitioner so often, and that is so difficult because he is so difficult to reach, because then I need to tell him my blood sugar for example, and then I have to be on hold and then I finally have the medical assistant, and then there’s an emergency call and I have to wait again. And now I can just type it through a secure system, and then I’m done” Implementation team1 |
“I thought it was really good, you [the implementation team] just gave a lot of time and attention, and were very easy to contact and yes, that was very nice, and everyone was really enthusiastic” General practitioner3 | |
“But the advantage of the ZWIP is of course that it’s a secure network, but that you can choose your own time for responding” Other professional1 | |
“Yes, I think the application is quite easy to work with” Professional conducting the screening1 | |
“And in that way I keep thinking like, well, that study has actually come ten years too early… with a generation that’s not, that didn’t grow up with computers, I think that’s a pity” General practitioner1 | |
“And also, last year it was of course also that issue around the, er, National Electronic Health Record, that made people think like, yes, is everything really that reliable….” Professional conducting the screening2 | |
“Or the security token didn’t work or they had the wrong token or you know, those actually small things but those were really annoying for the general practitioners” Implementation team1 | |
“For in these kind of projects, and there’s no way to do it differently, you have parallel development lines, you have simultaneously the trajectories of the educational program that’s being developed, that should start, the information technology, but at a certain time the information technology is not just as ready, and then the information technology is, but the goals or the patient education materials aren’t ready yet. So, and that’s because we were under a lot of pressure with the time…” Implementation team2 | |
“And then I’m quite a bad one to persuade people [to participate]. Probably because I’m not one-hundred percent convinced myself” Professional conducting the screening3 | |
Recommendations for future implementation of the ZWIP | “You can use it for every disease or every target population…and indeed, also with dementia, in palliative phases of patients when patients are still active themselves…” Implementation team1 |
“Yes, those [non-frail older people] who don’t, those who are still quite vital, who do have that age. They would…those are people who are much quicker eh, could work with it before they, before they really…and I think they might be able to benefit from it” Professional conducting the screening1 | |
“You could stimulate its use in small groups…for once I was in a community centre…then, we just sat with X and some older people, and then really around a round table, just re-enacting it. And then you see that people understand it much quicker and can also see that you are actually communicating” Implementation team3 | |
“I think that a lot of registration systems that those people have, eh, we have a different kind of registration system and the ZWIP is another, I think that many things can be linked to each other” Professional conducting the screening2 |