Determinants of change

Michel Wensing, Marije Caroline Bosch, Richard Grol

Research output: Chapter in Book/Report/Conference proceedingChapter (Book)Other


A wide range of factors can influence the process of the implementation of innovations in healthcare practice. These factors are related to the innovation that is implemented, the individuals who are expected to adopt it, the social setting in which they act, the healthcare organization, and health systems. The ?determinants of change? can strengthen or weaken the impact of implementation strategies. This chapter describes factors to be considered in a diagnostic analysis preceding a program for improving healthcare. A diagnostic analysis of determinants of implementation is an important component of planned implementation programs. A comprehensive diagnostic analysis comprises an analysis of stakeholders, identification of determinants related to specific goals for improvement, and identification of relevant subgroups among adopters of the innovation. Research evidence supporting the actual impact of specific determinants on process of implementation is limited. This chapter focuses on the impact of team processes on the uptake of innovations.
Original languageEnglish
Title of host publicationImproving Patient Care: The Implementation of Change in Health Care, Second Edition
EditorsRichard Grol, Michel Wensing, Martin Eccles, David Davis
Place of PublicationOxford, United Kingdom
PublisherJohn Wiley & Sons
Pages139 - 150
Number of pages12
ISBN (Print)9780470673386
Publication statusPublished - 2013

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