Exploring readiness for implementing goal-oriented care in primary care using normalization process theory.

Publisher: Cambridge University Press Country of Publication: England NLM ID: 100897390 Publication Model: Electronic Cited Medium: Internet ISSN: 1477-1128 (Electronic) Linking ISSN: 14634236 NLM ISO Abbreviation: Prim Health Care Res Dev Subsets: MEDLINE

Publication: Cambridge : Cambridge University Press
Original Publication: London : Arnold, c2000-

Motivation* ; Goals*; Humans ; Surveys and Questionnaires ; Primary Health Care ; Belgium ; Qualitative Research

Aim: To use normalization process theory (NPT) to build a strategy for the implementation of goal-oriented care (GOC) in primary care in Flanders, Belgium.
Background: GOC is a possible approach to more coordinated and integrated care and tailors care to patients' personal life goals. The concept has gained interest among policy makers and researchers, but the main drivers for successful implementation are the primary healthcare professionals (PHCPs) who need to see added value of GOC in order to embed it into their daily practice. NPT, developed to understand the processes of implementing new ways of organizing care, offers a useful lens to understand adoption of GOC in primary care practice.
Method: PHCPs ( n = 131) who participated in a 2-hour community meeting on GOC were asked to complete the Normalization MeAsure Development survey. This 23-item survey is based on NPT and describes participants' views about how an intervention would impact their work, their expectations about it, and whether it could become a routine part of their work.
Findings: The NPT constructs coherence (sense-making work) and cognitive participation (relational work) showed positive tendency toward implementation of GOC. The participants had an initial understanding on GOC and there was much interest in supporting and start working with this approach. The other constructs collective action (operational work) and reflexive monitoring (appraisal work) will need further efforts to trigger implementation. A common ground is needed to integrate GOC as a common practice which can be achieved by intensive interprofessional collaboration.

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Keywords: goal-oriented care; implementation; normalization process theory; primary care

Date Created: 20230208 Date Completed: 20230209 Latest Revision: 20230302

20240628

PMC9971852

10.1017/S1463423622000767

36752137