title: Professional commitment to changing chronic illness care: results from disease management programmes.
abstract: OBJECTIVE
  The aim of this exploratory study was to investigate to what extent primary care professionals are able to change their systems for delivering care to chronic obstructive pulmonary disease (COPD) patients and what professional and organizational factors are associated with the degree of process implementation.
  
  
  METHODS
  Quasi-experimental design with 1 year follow-up after intervention.
  
  
  METHODS
  Three regional COPD management programmes in the Netherlands, in which general practices cooperated with regional hospitals.
  
  
  METHODS
  All participating primary care professionals (n = 52).
  
  
  METHODS
  COPD management programme.
  
  
  METHODS
  Professional commitment, organizational context and degree of process implementation.
  
  
  RESULTS
  Professionals significantly changed their systems for delivering care to COPD patients, namely self-management support, decision support, delivery system design and clinical information systems. Associations were found between organizational factors, professional commitment and changes in processes of care. Group culture and professional commitment appeared to be, to a moderate degree, predictors of process implementation.
  
  
  CONCLUSIONS
  COPD management was effective; all processes improved significantly. Moreover, theoretically expected associations between organizational context and professional factors with the implementation of COPD management were indeed confirmed to some extent. Group culture and professional commitment are important facilitators.
authors.affiliation: Institute of Health Policy and Management, Erasmus University Medical Center, PO Box 1738, Rotterdam 3000 DR, The Netherlands. k.lemmens@erasmusmc.nl
authors.forename: Karin
authors.initials: K
authors.lastname: Lemmens
authors.forename: Mathilde
authors.initials: M
authors.lastname: Strating
authors.forename: Robbert
authors.initials: R
authors.lastname: Huijsman
authors.forename: Anna
authors.initials: A
authors.lastname: Nieboer
mesh_terms: D002985:Clinical Protocols; D003661:Decision Support Techniques; D019468:Disease Management; D006801:Humans; D007256:Information Systems; D009426:Netherlands; D010348:Patient Care Team / Q000458:organization & administration; D010353:Patient Education as Topic / Q000458:organization & administration; D011320:Primary Health Care / Q000458:organization & administration*; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D012648:Self Care / Q000379:methods