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Table 4 Joint display capability

From: A mixed methods multiple case study to evaluate the implementation of a care pathway for colorectal cancer surgery using extended normalization process theory

Capability: Possibilities presented by the complex intervention (Workability & Integration)

 

AR

(IR)

SrA

↑↓

LOS (ΔLOS)

Qualitative data

Hospital 1

75%

(10%)

88%

↑17

↓5

(6.0d)

(−3.1d)

• CP implemented before project, project used to update and adapt

• CP integrated in electronic patient record

• No effect on workload

• Standardization, monitoring mentioned as standard ways of working

Hospital 2

65%

(22%)

60%

↑18

↓3

8.2d

(− 4.2)

• CP implemented during project

• CP not integrated in patient record, but integrated in work processes

• Initial increase in workload

• Delicate process to reach consensus

Hospital 8

47%

(− 13%)

71%

↑6

↓9

10.3d

(− 4.4)

• No CP implemented

• Local protocol not integrated in the patient record

• Using protocol decreases workload

• Perioperative care is unstructured, depending on individual preferences

Hospital 9

54%

(−3%)

72%

↑13

↓6

10.2d

(2.1d)

• CP partly implemented during project, not integrated in patient record

• No effect on workload

• Ambivalent perception of standardization: clarity versus ‘cook book medicine’ and loss of autonomy

Hospital 10

64%

(−5%)

64%

↑7

↓8

18.8d

(1.8)

• CP implemented during project

• CP integrated in (paper based) patient record

• Decrease in workload

• Standardization perceived as positive providing clarity and safety

  1. AR Adherence rate post-test, IR Improvement rate, SrA Self-rated adherence, ↑↓ number of interventions on which adherence went up or down, LOS length of stay post-test, ∆LOS change in mean LOS (days)