Does Van Linge’s model provide a basis for the improvement of the early implementation phase of a quality management system in a physical therapy practice?

Abstract

Background Physical therapists are increasingly more focused on improving the quality and effectiveness of care. Quality improvement can be facilitated by the implementation of a quality management system.

Aim This study aims to explore the early implementation phase of a quality management system in order to improve quality in a physical therapy practice. For this exploration, Van Linge’s innovation contingency model is selected.

Methods Each of the participants from the physical therapy practice completed an organization and innovation characteristics questionnaire. Subsequently, they were interviewed about their implementation experiences, focusing on facilitators and barriers.

Results Results indicate a misfit between the systems ‘innovation’ and ‘organization’ in the innovation contingency model of Van Linge. This was shown in the early implementation phase of the quality management system in a physical therapy practice. This result is supported by the qualitative results from the interviews, in which organizational characteristics were reported as barriers, characteristics of the innovation were reported as facilitators and contextual characteristics were reported as both facilitators and barriers.

Conclusion There is a misfit between two systems of Van Linge’s model in the early implementation phase. This model is compatible to explore the fit or misfit in the early phase of implementation. The content of the interviews contributes to the exploration and explanation of the discovered misfit. Nevertheless, these results relate only to the participating practice and cannot be generalized. Further research should focus on generalizability.

Clinical Relevance Physical therapy practices that are in the early phase of implementation can use the innovation contingency model of Van Linge to detect the misfit. Subsequently, practices can set up a tailored implementation strategy in order to eliminate the misfit and to create a perfect fit for implementation. Previous research shows that good fit increases the chances of successful implementation.