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

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

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