What are the key contextual factors when preparing for successful implementation of assistive living technology in primary elderly care? A case study from Norway

Gjestsen, Martha Therese; Wiig, Siri; Testad, Ingelin

doi:10.1136/bmjopen-2016-015455

Cited by 24 publications

(29 citation statements)

References 38 publications

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“…It was also used as a means to demonstrate system complexity, through the interactions at the micro, meso and macro system levels [38,44,46,47,49,54,57,64,67,68,71], supporting the programme theory. Multiple interactions between different aspects of context were reported across the evidence, for example the influence of macro-level contexts on the micro system or the tensions and trade-offs between the two [38,43,49,52,53,57,60,63].…”

Section: Representations Of Context Within Improvement Settingsmentioning

confidence: 99%

“…Interactions between context and intervention were reported [54,68] and the interrelationship between intervention and context to achieve fit worked both ways: other studies reported on attempts to modify or 'improve' the local context prior to QI implementation in order to make it more supportive/receptive or to ameliorate the effects of contextual factors that impeded improvement efforts [48,51]. An example commonly mentioned was the alignment of national priorities to local work/improvement contexts or vice-versa [49,53,63]. However, misalignment of QI programme goals to local conditions/priorities, or an inability to achieve fit, was also highlighted [37,38,43,61,70] as a challenge when a mismatch between features of programme design/delivery and implementation contexts occurred.…”

Section: Managing Contextmentioning

confidence: 99%

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The influence of contextual factors on healthcare quality improvement initiatives: a realist review

et al. 2020

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Background: Recognising the influence of context and the context-sensitive nature of quality improvement (QI) interventions is crucial to implementing effective improvements and successfully replicating them in new settings, yet context is still poorly understood. To address this challenge, it is necessary to capture generalisable knowledge, first to understand which aspects of context are most important to QI and why, and secondly, to explore how these factors can be managed to support healthcare improvement, in terms of implementing successful improvement initiatives, achieving sustainability and scaling interventions. The research question was how and why does context influence quality improvement initiatives in healthcare? Methods: A realist review explored the contextual conditions that influence healthcare improvement. Realist methodology integrates theoretical understanding and stakeholder input with empirical research findings. The review aimed to identify and understand the role of context during the improvement cycle, i.e. planning, implementation, sustainability and transferability; and distil new knowledge to inform the design and development of context-sensitive QI initiatives. We developed a preliminary theory of the influence of context to arrive at a conceptual and theoretical framework. Results: Thirty-five studies were included in the review, demonstrating the interaction of key contextual factors across healthcare system levels during the improvement cycle. An evidence-based explanatory theoretical model is proposed to illustrate the interaction between contextual factors, system levels (macro, meso, micro) and the stages of the improvement journey. Findings indicate that the consideration of these contextual factors would enhance the design and delivery of improvement initiatives, across a range of improvement settings. Conclusions: This is the first realist review of context in QI and contributes to a deeper understanding of how context influences quality improvement initiatives. The distillation of key contextual factors offers the potential to inform the design and development of context-sensitive interventions to enhance improvement initiatives and address the challenge of spread and sustainability. Future research should explore the application of our conceptual model to enhance improvement-planning processes.

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Section: Representations Of Context Within Improvement Settingsmentioning

confidence: 99%

Section: Managing Contextmentioning

confidence: 99%

The influence of contextual factors on healthcare quality improvement initiatives: a realist review

et al. 2020

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“…It is about the economic use of all kinds of resources, together with managers that need to create a sustainable workplace for the healthcare professional, by providing enough learning and competence development and an attractive and interesting work. By being aware of the different motives of individuals related to healthcare work in municipalities, a higher success rate of using eHealth technologies can hopefully be obtained [13].…”

Section: Discussionmentioning

confidence: 99%

“…Even if the implementation of technology is on the agenda, the use of eHealth is not very well developed and the potential is far from exploited. Experiences from the use of eHealth so far show low success rates [13], and the interaction between technology and actors poses a major challenge [12].…”

Section: Introductionmentioning

confidence: 99%

Identifying Motives for Implementing eHealth by using Activity Theory

Svensson¹

2020

Sustainability

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eHealth interventions are utilized as a solution to address the current demographic challenges in society, as the number of old people increases. Thus, working life, work practice, and professional requirements needed for providing healthcare services will be transformed. The aim of this paper is to explore contradictive motives regarding the professionals' work practice when introducing innovative eHealth technologies in Scandinavian healthcare services at a municipal level. The study is based on two qualitative group interviews where nurses, assistant nurses, occupational and physiotherapists, as well as project managers participated. Two persons from an IT department were also interviewed. The interviews were analyzed by thematic analysis. The activity theory is used to explore the individuals' different contradictive motives in this work practice. The work practice consists of a collaborative activity, where expansive learning is important in this transformation of work to obtain a sustainable society. The motives identified in this study are to (1) improve quality of life for the patients, (2) create attractive and interesting work for the employees, (3) save money for the municipality, (4) learn about new technology, and (5) use the municipality's resources effectively.

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“…Welfare technology raises ethical questions concerning security, reliability, confidentiality, legal obligations, technology acceptance, and adoption, among other issues (Sánchez, Taylor, and Bing-Jonsson 2017). While there is a governmental push to develop and implement technology to be used in eldercare, there are numerous unanswered ethical questions, as well as a lack of laws and regulation, national infrastructure, and standards (Garmann-Johnsen and Eikebrokk 2017, Gjestsen, Wiig, andTestad 2017, Pols 2017); this situation has a negative impact on the municipalities' manoeuvring spaces. The results of a Norwegian study on the implementation of assistive living technology in primary eldercare have shown that the lack of guidance from national authorities regarding financial, legal, and technological aspects had a negative impact on the uptake of new technologies (Gjestsen, Wiig, and Testad 2017).…”

Section: Shift In Responsibilitiesmentioning

confidence: 99%

Narrative Review: Technologies in Eldercare

Frennert¹,

Östlund²

2018

NJSTS

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Background: Welfare technology is a concept that appears as one of the answers to how to meet the need for care in growing older populations. Although technology has been used for decades in eldercare, it is under-problematized and there is a lack of knowledge about how effective it really is. Objectives: This paper reviews the usage of technologies in eldercare and describes determinants of successful implementation of technologies in eldercare. The review aims to summarize and critically evaluate important aspects of technology usage in eldercare. Method: A narrative review method was selected for analysis of the literature. Through applying a narrative perspective to review the literature on technologies in eldercare, a broad understanding is gained of the contextual factors and main key success factors of implementing technologies in eldercare. Result: The review yield 71 publications related to technologies in eldercare. Seven themes were identified: (1) curriculum of technologies in eldercare; (2) on technologies; (3) evaluation models; (4) key success factors; (5) perception – care personnel; (6) perception – older users; and (7) controversies and dilemmas Discussion and Implications: The result of the review shows that technologies in eldercare are promoted to enable more seamless, efficient, patient-centered and safe care, however technologies might be contributing to making eldercare more fragmented, time-consuming, technology-centered and risky. Technologies in eldercare are only as successful and suitable as organizational culture, infrastructure and management practice allow them to be.

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What are the key contextual factors when preparing for successful implementation of assistive living technology in primary elderly care? A case study from Norway

Cited by 24 publications

References 38 publications

The influence of contextual factors on healthcare quality improvement initiatives: a realist review

The influence of contextual factors on healthcare quality improvement initiatives: a realist review

Identifying Motives for Implementing eHealth by using Activity Theory

Narrative Review: Technologies in Eldercare

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