Barriers and facilitators associated with the upscaling of the Transmural Trauma Care Model: a qualitative study

Julia Ratter; Suzanne Wiertsema; Ilham Ettahiri; Robin Mulder; Anne Grootjes; Julia Kee; Marianne Donker; Edwin Geleijn; Vincent de Groot; Raymond W J G Ostelo; Frank W Bloemers; Johanna M van Dongen

doi:10.1186/s12913-024-10643-7

Barriers and facilitators associated with the upscaling of the Transmural Trauma Care Model: a qualitative study

Julia Ratter, Suzanne Wiertsema, Ilham Ettahiri, Robin Mulder, Anne Grootjes, Julia Kee, Marianne Donker, Edwin Geleijn, Vincent de Groot, Raymond W J G Ostelo, Frank W Bloemers, Johanna M van Dongen

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

BACKGROUND: To assess the barriers and facilitators associated with upscaling the Transmural Trauma Care Model (TTCM), a multidisciplinary and patient-centred transmural rehabilitation care model.

METHODS: Semi-structured interviews were conducted with eight trauma surgeons, eight hospital-based physiotherapists, eight trauma patients, and eight primary care physiotherapists who were part of a trauma rehabilitation network. Audio recordings of the interviews were made and transcribed verbatim. Data were analysed using a framework method based on the "constellation approach". Identified barriers and facilitators were grouped into categories related to structure, culture, and practice.

RESULTS: Various barriers and facilitators to upscaling were identified. Under structure, barriers and facilitators belonged to one of five themes: "financial structure", "communication structure", "physical structures and resources", "rules and regulations", and "organisation of the network". Under culture, the five themes were "commitment", "job satisfaction", "acting as a team", "quality and efficiency of care", and "patients' experience". Under practice, the two themes were "practical issues at the outpatient clinic" and "knowledge gained".

CONCLUSION: The success of upscaling the TTCM differed across hospitals and settings. The most important prerequisites for successfully upscaling the TTCM were adequate financial support and presence of "key actors" within an organisation who felt a sense of urgency for change and/or expected the intervention to increase their job satisfaction.

TRIAL REGISTRATION: NL8163 The Netherlands National Trial Register, date of registration 16-11-2019.

Original language	English
Article number	195
Pages (from-to)	195
Journal	BMC health services research
Volume	24
Issue number	1
DOIs	https://doi.org/10.1186/s12913-024-10643-7
Publication status	Published - 13 Feb 2024

Bibliographical note

Funding

We thank all trauma patients and care providers (Haaglanden Medisch Centrum, HagaZiekenhuis, Noordwest Ziekenhuisgroep Alkmaar, Reinier de Graaf Ziekenhuis, and Spaarne Gasthuis; LUMC Leiden; Radboudumc Nijmegen; Amsterdam UMC, location AMC; and Maastricht UMC+) who participated in the study. We thank also Sidney Rubinstein for the translation of the quotes.

Funders	Funder number
Haaglanden Medisch Centrum

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Ratter, J., Wiertsema, S., Ettahiri, I., Mulder, R., Grootjes, A., Kee, J., Donker, M., Geleijn, E., de Groot, V., Ostelo, R. W. J. G., Bloemers, F. W., & van Dongen, J. M. (2024). Barriers and facilitators associated with the upscaling of the Transmural Trauma Care Model: a qualitative study. BMC health services research, 24(1), 195. Article 195. https://doi.org/10.1186/s12913-024-10643-7

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abstract = "BACKGROUND: To assess the barriers and facilitators associated with upscaling the Transmural Trauma Care Model (TTCM), a multidisciplinary and patient-centred transmural rehabilitation care model.METHODS: Semi-structured interviews were conducted with eight trauma surgeons, eight hospital-based physiotherapists, eight trauma patients, and eight primary care physiotherapists who were part of a trauma rehabilitation network. Audio recordings of the interviews were made and transcribed verbatim. Data were analysed using a framework method based on the {"}constellation approach{"}. Identified barriers and facilitators were grouped into categories related to structure, culture, and practice.RESULTS: Various barriers and facilitators to upscaling were identified. Under structure, barriers and facilitators belonged to one of five themes: {"}financial structure{"}, {"}communication structure{"}, {"}physical structures and resources{"}, {"}rules and regulations{"}, and {"}organisation of the network{"}. Under culture, the five themes were {"}commitment{"}, {"}job satisfaction{"}, {"}acting as a team{"}, {"}quality and efficiency of care{"}, and {"}patients' experience{"}. Under practice, the two themes were {"}practical issues at the outpatient clinic{"} and {"}knowledge gained{"}.CONCLUSION: The success of upscaling the TTCM differed across hospitals and settings. The most important prerequisites for successfully upscaling the TTCM were adequate financial support and presence of {"}key actors{"} within an organisation who felt a sense of urgency for change and/or expected the intervention to increase their job satisfaction.TRIAL REGISTRATION: NL8163 The Netherlands National Trial Register, date of registration 16-11-2019.",

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Ratter, J, Wiertsema, S, Ettahiri, I, Mulder, R, Grootjes, A, Kee, J, Donker, M, Geleijn, E, de Groot, V, Ostelo, RWJG, Bloemers, FW & van Dongen, JM 2024, 'Barriers and facilitators associated with the upscaling of the Transmural Trauma Care Model: a qualitative study', BMC health services research, vol. 24, no. 1, 195, pp. 195. https://doi.org/10.1186/s12913-024-10643-7

TY - JOUR

T1 - Barriers and facilitators associated with the upscaling of the Transmural Trauma Care Model

T2 - a qualitative study

AU - Ratter, Julia

AU - Wiertsema, Suzanne

AU - Ettahiri, Ilham

AU - Mulder, Robin

AU - Grootjes, Anne

AU - Kee, Julia

AU - Donker, Marianne

AU - Geleijn, Edwin

AU - de Groot, Vincent

AU - Ostelo, Raymond W J G

AU - Bloemers, Frank W

AU - van Dongen, Johanna M

PY - 2024/2/13

Y1 - 2024/2/13

N2 - BACKGROUND: To assess the barriers and facilitators associated with upscaling the Transmural Trauma Care Model (TTCM), a multidisciplinary and patient-centred transmural rehabilitation care model.METHODS: Semi-structured interviews were conducted with eight trauma surgeons, eight hospital-based physiotherapists, eight trauma patients, and eight primary care physiotherapists who were part of a trauma rehabilitation network. Audio recordings of the interviews were made and transcribed verbatim. Data were analysed using a framework method based on the "constellation approach". Identified barriers and facilitators were grouped into categories related to structure, culture, and practice.RESULTS: Various barriers and facilitators to upscaling were identified. Under structure, barriers and facilitators belonged to one of five themes: "financial structure", "communication structure", "physical structures and resources", "rules and regulations", and "organisation of the network". Under culture, the five themes were "commitment", "job satisfaction", "acting as a team", "quality and efficiency of care", and "patients' experience". Under practice, the two themes were "practical issues at the outpatient clinic" and "knowledge gained".CONCLUSION: The success of upscaling the TTCM differed across hospitals and settings. The most important prerequisites for successfully upscaling the TTCM were adequate financial support and presence of "key actors" within an organisation who felt a sense of urgency for change and/or expected the intervention to increase their job satisfaction.TRIAL REGISTRATION: NL8163 The Netherlands National Trial Register, date of registration 16-11-2019.

AB - BACKGROUND: To assess the barriers and facilitators associated with upscaling the Transmural Trauma Care Model (TTCM), a multidisciplinary and patient-centred transmural rehabilitation care model.METHODS: Semi-structured interviews were conducted with eight trauma surgeons, eight hospital-based physiotherapists, eight trauma patients, and eight primary care physiotherapists who were part of a trauma rehabilitation network. Audio recordings of the interviews were made and transcribed verbatim. Data were analysed using a framework method based on the "constellation approach". Identified barriers and facilitators were grouped into categories related to structure, culture, and practice.RESULTS: Various barriers and facilitators to upscaling were identified. Under structure, barriers and facilitators belonged to one of five themes: "financial structure", "communication structure", "physical structures and resources", "rules and regulations", and "organisation of the network". Under culture, the five themes were "commitment", "job satisfaction", "acting as a team", "quality and efficiency of care", and "patients' experience". Under practice, the two themes were "practical issues at the outpatient clinic" and "knowledge gained".CONCLUSION: The success of upscaling the TTCM differed across hospitals and settings. The most important prerequisites for successfully upscaling the TTCM were adequate financial support and presence of "key actors" within an organisation who felt a sense of urgency for change and/or expected the intervention to increase their job satisfaction.TRIAL REGISTRATION: NL8163 The Netherlands National Trial Register, date of registration 16-11-2019.

U2 - 10.1186/s12913-024-10643-7

DO - 10.1186/s12913-024-10643-7

M3 - Article

C2 - 38350997

SN - 1472-6963

VL - 24

SP - 195

JO - BMC health services research

JF - BMC health services research

IS - 1

M1 - 195

ER -

Barriers and facilitators associated with the upscaling of the Transmural Trauma Care Model: a qualitative study

Abstract

Bibliographical note

Funding

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