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Table 6 Results of SWOT analysis for evaluating and communicating the effectiveness of chronic disease management programs

From: The prevention and management of chronic disease in primary care: recommendations from a knowledge translation meeting

Strengths to leverage

Weaknesses to address

Stakeholders, Partnerships, and Knowledge Transfer of evaluation results

Legitimate interest of potential community partners e.g. pharmacists

Sincere interest in the program on the part of referring doctors, stakeholders, and clinicians

The evaluation provides a natural feedback mechanism. Patients who see an improvement in their health bring this information back to their family doctors

Evaluation process

Similarity of programs (all based on CCM)

Similarity of tools allows for the pooling of results to increase sample sizes and allow for comparison

Funding

Lack of resources for evaluation

Communication

Lack of referrals to the program and difficulty in reaching the target population (small sample size)—expressed as a lack of marketing and communication skills

Communication procedure are not well defined: need a mechanism to feed back patient outcomes to physicians and for them to communicate with the program to ask questions and see how their patient is doing

Stakeholders, partnerships, and knowledge transfer of evaluation results

Physicians not convinced about the efficacy of an interdisciplinary approach

Difficulty in legitimizing the projects to key actors, often family doctors

Difficulty in feeding back information about evaluation results to clinicians

Evaluation process

Different indicators between projects

 Need to establish key minimal indicators that must be collected throughout implementation

Evaluation timeline too short

Short timeline means incomplete implementation

Lost participation leading to missing data

Difficulty involving clinicians in the data collection process

The act of evaluating is seen as an intervention in itself. Good for implementation but might introduce bias for evaluation

Unclear definition of chronic diseases (ex. is cancer a chronic disease?)

Cannot ignore notion of cost-benefits as many stakeholders are interested in knowing about the long-term feasibility at the institution level

Lack of technology-supported tool

All stakeholders have different things they want to measure, achieve, and evaluate. This is hard to consolidate

Opportunities to optimise

Threat to mitigate

Stakeholders, Partnerships, and Knowledge Transfer of evaluation results

Funding

Improve involvement of family doctors to ensure their participation and ensure their sense that they have a role to play

Not enough funding for an evaluation to prove a program’s long-term effectiveness, which is needed to seek more funding

Integration with local and community resources (ex. YMCA, pharmacists, gyms, kinesiologists)—need to get creative in terms of partnerships

Make use of evaluation results to legitimize the projects to seek out funding and attract involvement of more people

Planning and financing of research—not enough resources to see the evaluation all the way through (implementation, evaluation, diffusion of results)

Stakeholders, partnerships, and knowledge transfer of evaluation results

Not enough publication of results to help decision makers

Evaluation process

Danger of saturating certain areas with too many similar projects

Synthesize the facilitating factors and challenges experienced by all projects

Pursue and create new partnerships by bringing down barriers with the community

Utilize existing resources like local regional tables to promote important networking opportunities

Bring professionals together to standardize care and information given to patients

While there are similarities in evaluation tools, this isn’t always the case—it will be a challenge to harmonize tools and projects in the future

Communication

Improve marketing and communication (ex. work with students). This can help bring awareness to the project and help researchers disseminate results

Clinical information systems could help in data collection—these are not available for most projects

Obtaining an adequate control group

Resistance to the evaluation of programs and of quality of care

Improve working conditions for professionals to incite them to participate in the program

Evaluation process

Need to evaluate costs - both cost of implementation and cost- effectiveness of project

 

Do better job of evaluating physician dropout rates