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Objectives Telemedicine is extensively used in healthcare settings, although we still lack knowledge on how to make telemedicine services last over time. This study aims to: investigate how the factors supporting the implementation of telemedicine services affect their duration over time; explore if further factors need to be considered, to foster the services duration. Methods We conducted a six-year in-depth study on three Italian cases of telemedicine services lasting more than 10 years. Dimensions explaining the duration of services over time are explored and discussed against existing literature. Results The three cases show that, to support the duration over time, financial and organizational stability should be set before the “champion” leaves the service. Financial stability was reached through different strategies. About organizational stability, we found that providing opportunities to enrich the competences and getting more responsibilities over the patients enhanced the professionals’ acceptance, which, in turn, supports the organizational stability of the service over time. About patients, to meet their crucial needs for their health and to receive the nurses’ support on the use of technologies contains the abandon and increases the chances for the service to last over time. Last, the three services observed pursued a strategy of focalization on a specific need. Conclusions The findings provide insights for policy makers and hospital managers on how to set effective services and avoid service abandon, thus reducing waste of resources, and on how to motivate the professionals and patients, by increasing the chances of duration of the services over time.

Purpose The purpose of this paper is to study four cases of the adoption of co-production and compare them according to the type of user involvement, contextual factors and the organizational structure. Design/methodology/approach In total, 30 interviews were conducted in four mental health organizations which are implementing co-production in the North of Italy. Interviews were conducted with clinicians, nurses, patients and family members. The data collected was triangulated with further sources and official documents of organizations. The results have been compared by means of a validated international framework (IAP2) regarding the contextual factors and the level of co-production adopted. Findings The adoption of co-production in the four cases differs by the activities implemented and how organizations involve informal actors. It seems to be influenced by the contextual factors specific to each organization: power, professionals’ opinions and leadership. Organizations whose practitioners and leaders are willing to distribute their power and value informal actors’ opinions seem to facilitate the systematic involvement of users. Overall, the results highlight the importance of considering contextual factors when evaluating and describing co-production activities. Originality/value This paper contributes to describing how mental health organizations are implementing co-production. It examines the influence of contextual factors on the type of co-production adopted.

Summary The aim of this contribution is to explain how healthcare professionals implement policies for integrated care. More specifically, we aim to understand how these policies are received, interpreted and executed by primary care professionals. By opening the “black box” of policy implementation, we also explain how and why the process of implementation of the same policy diverges in practice. The research is framed according to both the neo-institutional and the change management perspectives. The empirical investigation is conducted through a documental analysis and a multiple-embedded case study. The results show that three forces affect and explain differences in the implementation processes: the unstable level of internal communication among the professionals involved, the limited use of power to resist to change and the poor learning process on the part of both the professionals and policy makers. The pressure of external institutions does not play a role in shaping the process. Through our study, we further knowledge about how healthcare professionals implement policies for integrated care, and we believe this is interesting, according to emerging evidence that variations in the effectiveness of policy outcomes may be explained by choices and potential distortions made during the initial stages of the policy implementation process. Copyright © 2015 John Wiley & Sons, Ltd. StartCopTextCopyright © 2015 John Wiley & Sons, Ltd.

The aim of this contribution is to explain how healthcare professionals implement policies for integrated care. More specifically, we aim to understand how these policies are received, interpreted and executed by primary care professionals. By opening the "black box" of policy implementation, we also explain how and why the process of implementation of the same policy diverges in practice. The research is framed according to both the neo-institutional and the change management perspectives. The empirical investigation is conducted through a documental analysis and a multiple-embedded case study. The results show that three forces affect and explain differences in the implementation processes: the unstable level of internal communication among the professionals involved, the limited use of power to resist to change and the poor learning process on the part of both the professionals and policy makers. The pressure of external institutions does not play a role in shaping the process. Through our study, we further knowledge about how healthcare professionals implement policies for integrated care, and we believe this is interesting, according to emerging evidence that variations in the effectiveness of policy outcomes may be explained by choices and potential distortions made during the initial stages of the policy implementation process. Copyright © 2015 John WileySons, Ltd. StartCopTextCopyright © 2015 John WileySons, Ltd.