Skip to main content

Advertisement

Table 2 External factors and preconditions before starting the implementation that can influence the implementation process

From: Towards personalized integrated dementia care: a qualitative study into the implementation of different models of case management

  Intensive Linkage Nivel
Characteristics of case management    
Facilitating Using existing non-dementia case management models as example +   
Impeding Disagreement about content of case manager tasks   - -
Partners do not see the added value of a case manager who only mediates   -  
Speed of implementation depends on mentality and cultural values of the region   -  
Time and other operational preconditions    
Facilitating Sufficient time to set up an organizational structure   + +
Impeding Professionals don't have innovation time; consensus among many collaboration partners takes time -   
No clear guidelines for implementation   - -
Human and financial resources    
Facilitating Retraining district nurses to become case managers facilitates collaboration with the GP as they have pre-existing partnerships +   
Presence of a clear initiator of the implementation +   
Impeding Proliferation of different types of case managers created friction among providers   - -
Lack of clarity about the role of the project leader (not knowing who is their superior)   -  
Organizational conditions    
Facilitating Embedding case management in Mental Health Care promotes collaboration +   
Embedding the multidisciplinary expert team in case management organization +   
Good collaboration between case managers from competitive providers provides the opportunity to learn from each other   + +
Case managers from one provider all working in the same room enhances sparring and consultation   +  
Presence of a Board of Representatives to guide the dementia care network.   + +
Presence of fixed stakeholders at partners in the dementia care network whom case managers can contact +   +
Impeding Presence of competitive providers of case management within the dementia care network   - -
Different interests of the Board of Representatives; incomplete attendance during meetings; members without mandate to make decisions.   -  
Expert team doe not function properly; difficult to reach clinicians as members participate only a few hours per week. -   
Lack of clarity about who is responsible for what aspects of implementation and collaboration   -  
  Only incorporating dementia care partners with the strongest pre-existing relationships at the start -   
  1. + = facilitating factor, - = impeding factor, a blank cell means a factor was not extracted from interviews in regions within this model or the Nivel study.