Supporting evaluation and implementation of musculoskeletal Models of Care: A globally-informed framework for judging 'readiness' and 'success'.

Objective To develop a globally-informed framework to evaluate 'readiness' for implementation and 'success' after implementation of musculoskeletal Models of Care (MoCs). Methods Three-phases were undertaken: 1) qualitative study with 27 Australian subject matter experts (SMEs) to develop a draft Framework; 2) eDelphi study with an international panel of 93 SMEs across 30 nations to evaluate face validity, refine and establish consensus on the Framework components; and 3) translation of the Framework into a user-focused resource and evaluation of its acceptability with the eDelphi panel. Results A comprehensive evaluation framework was developed for judging 'readiness' and 'success' of musculoskeletal MoCs. The Framework consists of nine domains, with each domain containing a number of themes underpinned by detailed elements. In the first Delphi round, scores of 'partly agree' or 'completely agree' with the draft Framework ranged from 96.7-100%. In the second round, 'essential' scores ranged from 58.6-98.9%, resulting in 14 of 34 themes being classified as essential. SMEs strongly agreed or agreed that the final Framework was useful (98.8%), usable (95.1%), credible (100%) and appealing (93.9%). Overall, 96.3% strongly supported or supported the final structure of the Framework as it was presented, while 100%, 96.3% and 100% strongly supported or supported the content within the readiness, initiating implementation and success streams, respectively. Conclusions An empirically-derived framework to evaluate the readiness and success of musculoskeletal MoCs was strongly supported by an international panel of SMEs. The Framework provides an important internationally-applicable benchmark for the development, implementation and evaluation of musculoskeletal MoCs. This article is protected by copyright. All rights reserved

The occurrence of acute myocardial infarction in Italy: a five-year analysis of hospital discharge records

The incidence and costs of acute myocardial infarction (AMI) in Europe represent a substantial problem due to population aging