title: Middle Managers' Experiences and Role in Implementing an Interactive Tailored Patient Assessment eHealth Intervention in Clinical Practice.
abstract: The role of nurse and physician managers is considered crucial for implementing eHealth interventions in clinical practice, but few studies have explored this. The aim of the current study was to examine the perceptions of nurse and physician managers regarding facilitators, barriers, management role, responsibility, and action taken in the implementation of an eHealth intervention called Choice into clinical practice. Individual qualitative interviews were conducted with six nurses and three physicians in management positions at five hospital units. The findings revealed that nurse managers reported conscientiously supporting the implementation, but workloads prevented them from participating in the process as closely as they wanted. Physician managers reported less contribution. The implementation process was influenced by facilitating factors such as perceptions of benefits from Choice and use of implementation strategies, along with barriers such as physician resistance, contextual factors and difficulties for front-line providers in learning a new way of communicating with the patients. The findings suggest that role descriptions for both nurse and physician managers should include implementation knowledge and implementation skills. Managers could benefit from an implementation toolkit. Implementation management should be included in management education for healthcare managers to prepare them for the constant need for implementation and improvement in clinical practice.
authors.affiliation: Author Affiliations: Center for Shared Decision Making and Collaborative Care Research (Ms Varsi, Drs Ekstedt and Gammon, Ms Børøsund, and Dr Ruland), Oslo University Hospital; and Faculty of Medicine (Mss Varsi and Børøsund and Dr Ruland), University of Oslo, Norway; Royal Institute of Technology (Dr Ekstedt), KTH, School of Technology and Health, Stockholm, Sweden; and Norwegian Centre for Integrated Care and Telemedicine (Dr Gammon), University Hospital in North Norway, Tromsø.
authors.forename: Cecilie
authors.initials: C
authors.lastname: Varsi
authors.forename: Mirjam
authors.initials: M
authors.lastname: Ekstedt
authors.forename: Deede
authors.initials: D
authors.lastname: Gammon
authors.forename: Elin
authors.initials: E
authors.lastname: Børøsund
authors.forename: Cornelia M
authors.initials: CM
authors.lastname: Ruland
mesh_terms: D000288:Administrative Personnel; D006284:Health Plan Implementation / Q000379:methods*; D006801:Humans; D007324:Institutional Management Teams / Q000458:organization & administration*; D008875:Middle Aged; D009718:Nurse Administrators; D048108:Nursing Informatics; D005791:Patient Care; D010820:Physicians; D036301:Qualitative Research; D017216:Telemedicine