Tip 6: ‘Adaptation of priorities and strategies in program’s implementation process´

The priorities and strategies of implementation process should be adapted to support organizational change, ICT development and for a clear business model.



The Prehabilitation program has been deployed, as planned, in a local context. Program efficacy has been demonstrated in a recent RCT*. Moreover, we have identified high potential for cost-effectiveness as well as potential to develop a peri-surgical care program. New strategies are necessary to implement this program in Catalonia. Full maturity of the service should be achieved through: (1) evaluation of the prehabilitation unit at the Hospital Clínic in Barcelona; (2) development of an ICT platform integrated with current healthcare providers, and (3) refinement of the business service workflow. The latter has been done in three workshops: refining the service design, redefining regional extension, and identification of business models to provide sustainability.
* published in the Annals of Surgery (A Barberan-Garcia, 2017), printed version will be published in vol 267 – January 2018


Transfer to other settings:
  • Use the collaborative methodology to clearly define the objectives, what to scale, what adaptations to the service are required, and ensure you address organizational changes necessary.
  • You need a framework for rapid improvement, using the collaborative methodology will enable a way to do it in small iterations and keep progressing.
  • You need a clear evaluation to decide if your project was a success or not.


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