Health Care Home implementation in Otago and Southland: a qualitative evaluation.

Introduction. Health systems internationally have developed new models of primary care to address health-care challenges. One such model is the Health Care Home (HCH), which has been widely adopted across New Zealand. Aim. To explore the facilitators and barriers to implementation of the HCH in the...

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Publicado en:Journal of Primary Health Care Vol. 14; no. 2; pp. 130 - 138
Autores principales: Gagan Gurung, Barson, Stuart, Haughey, Marc, Stokes, Tim
Formato: research tables/charts Journal Article
Publicado: CSIRO Publishing Jun2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2022
      vid: 14
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      pub: CSIRO Publishing
      place: Canberra ACT, <Blank>
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        157754067
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        10.1071/HC22032
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        atl: Health Care Home implementation in Otago and Southland: a qualitative evaluation.
      aug:
        au:
          Gagan Gurung
          Barson, Stuart
          Haughey, Marc
          Stokes, Tim
        affil: Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand
      sug:
        subj:
          Health Services New Zealand
          Program Implementation
          Implementation Science
          Human
          Qualitative Studies
          New Zealand
          Semi-Structured Interview
          Thematic Analysis
          Descriptive Statistics
          Male
          Female
          Male
          Female
      ab: Introduction. Health systems internationally have developed new models of primary care to address health-care challenges. One such model is the Health Care Home (HCH), which has been widely adopted across New Zealand. Aim. To explore the facilitators and barriers to implementation of the HCH in the southern health district (Otago and Southland). Methods. Interviews with staff (n = 15) from seven general practices were undertaken. A rapid thematic analysis informed by the Consolidated Framework for Implementation Research (CFIR) was conducted using the framework method. Results. A number of implementation facilitators and barriers across three CFIR domains were identified: intervention characteristics, inner setting and implementation process. The intervention - the HCH - has well-designed core components (eg clinician triage, patient portals), but the adaptable periphery also needs addressing to ensure the core components fit the local context. In the inner setting, a positive implementation climate and readiness for change (a strong need for the change, compatibility, strong leadership, availability of resources, and a clear understanding of the HCH and timely practical support) were key for successful implementation. Although the HCH practices had detailed planning and performance monitoring systems in place, a successful implementation process required having a change management plan and ensuring whole-of-practice engagement. Discussion. This evaluation has identified facilitators and barriers to implementing the HCH in one health district using implementation science theory (CFIR). It is imperative to tailor the HCH model to local needs and individual general practices for successful implementation.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
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      ougenre: Article
    language: English
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