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To bridge the gap between scientific evidence and patient care we need an in-depth understanding of the barriers and incentives to achieving change in practice. Various theories and models for change point to a multitude of factors that may affect the successful implementation of evidence. However, the evidence for their value in the field is still limited.(More)
BACKGROUND A consulting method known as 'shared decision making' (SDM) has been described and operationalized in terms of several 'competences'. One of these competences concerns the discussion of the risks and benefits of treatment or care options-'risk communication'. Few data exist on clinicians' ability to acquire skills and implement the competences of(More)
BACKGROUND A systematic review has shown that no measures of the extent to which healthcare professionals involve patients in decisions within clinical consultations exist, despite the increasing interest in the benefits or otherwise of patient participation in these decisions. AIMS To describe the development of a new instrument designed to assess the(More)
BACKGROUND Changing the organization of patient care should contribute to improved patient outcomes as functioning of clinical teams and organizational structures are important enablers for improvement. OBJECTIVE To provide an overview of the research evidence on effects of organizational strategies to implement improvements in patient care. DESIGN(More)
BACKGROUND The assumption underlying tailoring is that implementation interventions are most helpful if these effectively address the most important determinants of practice for improvement in the targeted setting. The aim of the Tailored Implementation For Chronic Diseases (TICD) project is to develop valid and efficient methods of tailoring implementation(More)
BACKGROUND Internationally, different organizational models are used for providing out-of-hours care. The aim of this study was to assess prevailing models in order to identify their potential strengths and weaknesses. METHODS An international web-based survey was done in 2007 in a sample of purposefully selected key informants from 25 western countries.(More)
Objective: To measure the effectiveness of strategies to implement clinical guidelines and the influence of organisational characteristics on hospital care. Methods: Systematic review and meta regression analysis including randomised controlled trials, controlled clinical trials and controlled before-and-after studies. Results: 53 studies were identified,(More)
BACKGROUND Many patients with chronic illness receive health care in primary care settings, so a challenge is to provide well-structured chronic care in these settings. Our aim was to develop and test a Dutch version of the PACIC questionnaire, a measure for patient reported structured chronic care. METHODS Observational study in 165 patients with(More)
OBJECTIVE This study examined the effectiveness of the German diabetes disease management program (DMP) for patients with varying numbers of other medical conditions with respect to their health-related quality of life (HRQoL). RESEARCH DESIGN AND METHODS A questionnaire, including the HRQoL-measured EQ-5D, was mailed to a random sample of 3,546 patients(More)
BACKGROUND Supporting self-management intends to improve life-style, which is beneficial for patients with mild osteoarthritis (OA). We evaluated a nurse-based intervention on older OA patients' self-management with the aim to assess its effects on mobility and functioning. METHODS Randomized controlled trial of patients (> or = 65 years) with mild hip or(More)