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Introduction: In response to fragmentation and standardization in care for people with chronic conditions, together with an alarming workload for professionals, the TARGET program was developed. In short, it Targets Advanced Resources in General practice to create Efficient, Tailored and holistic care. TARGET introduces (1) a tool to divide patients in subgroups with different care needs; (2) a person-centered needs assessment (PCNA) and (3) support with creating an efficient network around the general practice. To increase insight into the feasibility and acceptability of the program before implementing this complex program on a larger scale, this pilot study was conducted. Methods: A multiple case study was conducted. Each of the seven general practices that implemented TARGET in the Dutch province of Drenthe for six months, from September 2020, was considered a ‘case’. The number of professionals who implemented the program differed between practices: from an individual up to a team of several professionals. The implementation of the program elements was focused on patients in the ‘high care need’ subgroup who were assumed to benefit most from TARGET. We conducted observations of the trainings and PCNAs, and semi-structured interviews with professionals and patients. The interviews were analyzed using thematic inductive analyses.Key findings: We interviewed 15 professionals who implemented TARGET and 12 patients who received a PCNA. The key findings were: (1) Professionals reported that due to the TARGET trainings they felt well equipped to use the segmentation tool and to engage in the PCNAs. (2) The PCNAs were appreciated by professionals and patients as it gave the opportunity to talk about other issues – for example the positive aspects of a patient’s life – than usually addressed. (3) Possible successive actions were often discussed during the PCNA, but referrals were rarely made. This was, amongst others, due to a limited network of professionals to refer to or cooperate with. (4) Professionals experienced higher work satisfaction due to more time for valuable attention for patients. (5) A lower work pressure was not yet experienced as learning new skills and tools required time and energy, especially in practices with limited team commitment. Conclusions: Implementing TARGET is time intensive yet considered feasible, especially when there is strong team involvement and a shared vision. Furthermore, the acceptability was high amongst professionals and patients as they reported that the PCNAs contributed to valuable, well-suited person-centered care. Overall, professionals wanted to continue with TARGET. Implications for applicability: As the TARGET program was largely considered feasible and acceptable, implementation of the program on a larger scale is legitimate. Yet, to improve the impact of the program on, for instance, work pressure, referral opportunities for general practices and team commitment to the implementation should be further improved and stimulated. |
