Protocol for an implementation and realist evaluation of a new organisational model for primary care practices in the canton of Vaud, Switzerland.

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Version: Final published version
License: CC BY-NC 4.0
Serval ID
serval:BIB_9AE5E29A0A2C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Protocol for an implementation and realist evaluation of a new organisational model for primary care practices in the canton of Vaud, Switzerland.
Journal
BMJ open
Author(s)
Schutz Leuthold M., Schwarz J., Marti J., Perraudin C., Hudon C., Peytremann-Bridevaux I., Senn N., Cohidon C.
ISSN
2044-6055 (Electronic)
ISSN-L
2044-6055
Publication state
Published
Issued date
10/12/2020
Peer-reviewed
Oui
Volume
10
Number
12
Pages
e040154
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Continuity of care, especially for patients with complex needs, is a major challenge for healthcare systems in many high-income countries, including Switzerland. Since 2015, a collaborative project between Unisanté-Department of Family Medicine (DMF), some general practitioners (GPs) and canton of Vaud's public health authorities has sought to develop a new organisational model for the provision of primary care to ensure better care coordination and to provide adapted care deliveries to patients' healthcare needs. The model's main component is the addition of a primary care nurse to GPs practices. Three additional tools are individualised patient care plans, electronic medical records and patient empanelment. To assess this model, a 2-year pilot study has begun in nine GPs' practices in the canton. This paper presents the protocol for an evaluation of the implementation and effectiveness of the new organisational model.
We will conduct a before-and-after study using a mixed-methods and a realist approach. First, we will use quantitative and qualitative data to assess the new organisational model's implementation (feasibility, fidelity, acceptability and costs) and effectiveness (healthcare services use, patient experience, staff experience and patient-level costs). Combining this data with focus group data will enable a realist evaluation of the pilot project, which will help understand the elements of context and mechanism that affect implementation.
The evaluation will inform the canton of Vaud's health authorities about the limits of and perspectives for this organisational model. All results will also be made available to the practices and the patients involved. At the end of the project, we will propose organisational adaptations and a sustainable financial model for extending the model to other practices in the canton and potentially to the national level.The canton of Vaud's Human Research Ethics Committee approved the study, and Data Protection and Information Law Authority gave a favourable opinion concerning data processing procedures.
Keywords
general medicine (see Internal Medicine), organisation of health services, primary care
Pubmed
Open Access
Yes
Create date
14/12/2020 12:30
Last modification date
30/04/2021 7:13
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