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In addition to these four approaches carried out by the research team, stakeholders will be invited to keep reflective diaries on the issues they face when putting guidance into practice and to gather their ideas about the kinds of changes that might mitigate the difficulties to implementation.
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There was a clear, formal acknowledgment of the need and expectations for using patient experience and patient involvement in QI on one hand, but also by difficulties and barriers to implementation on the other.
As Mr Lamfalussy observes, "it is when you come to implementation that many difficulties of principle resurface".
The main reasons for non-usage of teleradiology are lack of financial means (23 %) and technical difficulties related to implementation on an organisational level (21 %), or absence of PACS (9 %).
Firstly, our analysis considers costs and effectiveness of interventions, but it does not address health systems constraints that add difficulties to the actual implementation of the interventions.
Differences between the results of an intention-to-treat analysis and a per-protocol analysis or additional sensitivity analyses may point to implementation difficulties and may highlight areas for future research.
15 For all that this initiative fulfilled many of the criteria for success delineated by Greenhalgh et al, 8 it appears to have encountered similar difficulties in implementation to other service improvement initiatives.
Members of commune councils we interviewed conveyed that they did not have difficulty managing their functions related to implementation of CPS and were supportive of efforts to expand preschools.
Irregular payments to treatment supporters further contributed to difficulties in intervention implementation, and would need to be addressed if the programme were implemented more widely.
The paper addresses the problem to recognize a level of robust controller design in our Institute and show the difficulties of implementation to student courses.
You alluded to difficulties with implementation.
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