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093 Measurement Instrument for Determinants of Innovations (MIDI)
  1. M Fleuren,
  2. T Paulussen,
  3. P van Dommelen,
  4. S van Buuren
  1. TNO, Leiden, Netherlands

Abstract

Background In 2002, we developed a list of 60 potential relevant determinants that are critical for a successful implementation of innovations in health care, such as guidelines. This list was a result of a review of empirical studies and a Delphi study among implementation experts. Since 2002, we used the list in eight empirical studies concerning the implementation of guidelines/programs.

Objectives The development of a generic measurement instrument for the assessment of determinants of implementation of innovations.

Methods In each study, a similar method was used to measure implementation of the guideline/program as well as the determinants. The information of the eight empirical studies were combined into one data set. Missing values in the final data set were replaced by plausible values using multiple imputation. We assessed which determinants ‘predict’ the implementation: separately and in combination with each other. In addition, 22 implementation experts commented on the results of the meta-analyses.

Results An instrument with 29 determinants was established; 7 are related to the guideline/programme itself; 11 to the user; 11 to the organisation and socio-political context.

Discussion This instrument is to be used before or after a guideline is introduced in order to gain insight into critical determinants that need to be targeted in order to improve implementation.

Implications for Guideline Developers/Users Since 7 determinants are related to the innovation itself (e.g. clear procedures) developers should take these into account when developing a guideline.

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