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BMC Health Services Research

, 17:331

Organization, structure and delivery of healthcare


BackgroundThe lack of proven efficacy of new healthcare interventions represents a problem for health systems globally. It is partly related to suboptimal implementation processes, leading to poor adoption of new interventions. Activation of Stratification Strategies and Results of the interventions on frail patients of Healthcare Services ASSEHS EU project N° 2013 12 04 aims to study current existing health Risk Stratification RS strategies and tools on frail elderly patients. This paper aims at identifying variables that make the implementation of population RS tools feasible in different healthcare services.

MethodsTwo different methods have been used to identify the key elements in stratification implementation; i a Scoping Review, in order to search and gather scientific evidence and ii Semi-structured interviews with six key experts that had been actively involved in the design and-or implementation of RS strategies. It aims to focus the implementation construct on real-life contextual understandings, multi-level perspectives, and cultural influences.

ResultsA Feasibility Framework has been drawn. Two dimensions impact the feasibility of RS: i Planning, deployment and change management and ii Care intervention. The former comprises communication, training and mutual learning, multidisciplinarity of the team, clinicians’ engagement, operational plan and ICT display and functionalities. The latter includes case finding and selection of the target population, pathway definition and quality improvement process.

ConclusionsThe Feasibility Framework provides a list of key elements that should be considered for an effective implementation of population risk stratification interventions. It helps to identify, plan and consider relevant elements to ensure a proper RS implementation.

Electronic supplementary materialThe online version of this article doi:10.1186-s12913-017-2275-3 contains supplementary material, which is available to authorized users.

Autor: Joana Mora - Miren David Iturralde - Lucía Prieto - Cristina Domingo - Marie-Pierre Gagnon - Catalina Martínez-Carazo - A


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