Implementing a care pathway for elderly patients, a comparative qualitative process evaluation in primary care

Table 3 Differences in implementation status and implementation process in six municipalities (A-F)

	Municipalities
	A	B	C	D	E	F
	PaTH in use in full scale¹		Elements of PaTH in use¹		PaTH not in use¹
Makes sense (coherence ² )
Expecting PaTH to be useful	Yes	Yes	Yes	Yes	Yes	Yes
Regular staff understood how to use PaTH	Mixed	Mixed	Mixed	Mixed	Mixed	Mixed
Commitment and engagement (cognitive participation ² )
Sustained leadership	Yes	Yes	No	No	No	No
Practice in using checklists	Intensive	Intensive	Minimal	Minimal	Minimal	Minimal
General attention to PaTH at workplace	Yes	Yes	No	Nurses only	No	No
Facilitating use of PaTH (collective action ² )
Extra personnel resources	Yes	Yes	No	Yes	No	No
Major competing priorities	No	No	No	No	Yes	Yes
Usability in electronic health record	Good	Fair	Poor	Poor	Poor	Poor
Working schedule facilitated for PaTH	Yes	Yes	No	No	No	No
Checklists incorporated in daily routines	Yes	Yes	No	No	No	No
Value of PaTH (reflexive monitoring ² )
Impact on collaboration with the hospital	Mixed	Mixed	No	No	No	No
Impact on collaboration with GPs	Yes	Yes	No	Yes	No	No
Impact on service quality	Yes	Yes	No	Yes	No	Yes
Value for individual nurse/nursing assistant	Yes	Yes	No	No	No	No
Valued as a management tool	Yes	Yes	No	Yes	No	No

¹Assessed 24 months (B-F) and 32 months (A) after introduction of PaTH in the municipalities.
²Core constructs of the Normalization Process Theory.

ISSN: 1472-6963