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What is the reach, dose delivered, dose received and fidelity of the Transmural Trauma Care Model (TTCM)? What are the barriers and facilitators associated with the implementation of the TTCM? Mixed-methods process evaluation with quantitative evaluation of the extent to which the TTCM was implemented as intended and qualitative evaluation of barriers and facilitators to its implementation. Focus group participants included trauma patients, trauma surgeons, hospital-based physiotherapists and primary care network physiotherapists. Implementation was assessed with reach, dose delivered, dose received and fidelity. A framework method was used to analyse the focus groups and the 'constellation approach' was used to categorise barriers and facilitators into three categories: structure, culture and practice. The TTCM's reach was 81%, its dose delivered was 99% and 100%, and its dose received was 95% and 96% for the multidisciplinary TTCM consultation hours at the outpatient clinic for trauma patients and the primary care network physiotherapists, respectively. Various fidelity scores ranged from 66 to 93%. Numerous barriers and facilitators associated with the implementation of the TTCM were identified and categorised. This process evaluation showed that the TTCM was largely implemented as intended. Furthermore, various facilitators and barriers were identified that need to be considered when implementing the TTCM more widely. Differences were found among stakeholders but they were generally of the opinion that if the barriers were overcome, the quality of care and patient satisfaction were likely to improve significantly after implementing the TTCM. NTR5474. [ABSTRACT FROM AUTHOR]

Background: The Western Ontario Rotator Cuff Index (WORC) is a disease-specific shoulder questionnaire, originally developed at the University of Western Ontario, to measure quality of life in patients with rotator cuff disease (RCD). The aim of the present study was to cross-culturally adapt the WORC for use in the Netherlands and to evaluate the reproducibility in patients with RCD. Materials and methods: The WORC was translated into Dutch according to leading guidelines in the literature, and 52 patients with RCD completed the questionnaire twice within 2 weeks. The Cronbachs α and the intraclass correlation coefficient (ICC) were calculated, Bland-Altman analysis was applied, and the smallest detectable change (SDC) and reliable change index (RCI) were determined. Results: The Cronbachs α ranged from 0.91 to 0.97 for the total WORC score and for the 5 domains. High ICCs were found for the WORC total score (0.94) and for the separate domains (range, 0.85-0.91). Bland-Altman analyses showed no systematic differences between assessments. SDC was 355.7 for the total WORC score, varying from 80.4 to 148.0 for the domains, resulting in RCIs of 16.9% for the total WORC score and 24.7% to 30.2% for the domains. Conclusions: The results of the present study suggest good reproducibility of the Dutch version of the WORC in Dutch-speaking patients with RCD. Additional research on the validation of the Dutch version of the WORC is required in the near future. [ABSTRACT FROM AUTHOR]