Digitalisation of municipal healthcare collaboration with volunteers: a case study applying normalization process theory

Abstract

Abstract Background Increasing use of volunteers in healthcare requires structured collaboration between healthcare services and volunteers. The aim of this research was to explore critical issues and strategies in the implementation process of a digital solution for collaboration with and coordination of volunteers in municipal healthcare services. Methods Qualitative data collection was used to study implementation of a digital system for collaboration with volunteers in three Norwegian municipalities. Three rounds of interviews were conducted with healthcare employees from a volunteer centre and from municipality healthcare units in three municipalities: before implementation, and 6 and 12 months after deployment. Observations of healthcare employees training and use of the system were also done. Results An inductive analysis resulted in eleven themes that were grouped based on the four constructs of the normalisation process theory (NPT), plus two themes that fall outside those constructs. Coherence (understanding of the intervention) was high among the employees prior to the intervention. They expected the system to meet several of their needs and increase efficiency, structure and overview. In addition, they expected the system to benefit recruitment strategies along with their matching processes. Cognitive participation (engagement and commitment towards the intervention): employees from two of the municipalities reported absence of leadership and management guidance during the process, management of expectations and clarification of their roles. In the third, there was high engagement and management involvement in the implementation process. Collective action (whether the intervention is carried out): the employees reported time-consuming preparations. Engagement varied between the municipalities. There was a lack of commitment in two due to ongoing reorganisation, in these, the system was partly or not implemented. The third municipality implemented and fully piloted the system. Reflexive monitoring (appraisal towards the system and its impact on practice): the employees learned throughout testing of the system and realised that there were several benefits that could improve their working routines. Conclusion Crucial aspects for implementation of the digital tool for collaboration with volunteers include having structure “in place”, establishing policies for involving volunteers, defining clear roles and expectations and involving management and key people (“champions”) to drive the implementation.