|Health care region||Challenges||Strengths|
|ESSOTE||A simultaneous extensive organizational change (fusion of primary and secondary health care organizations, including relocation of primary care facilities)||Research nurses and the principal investigator can remind/educate professionals of the new protocol from time to time.|
During the re-evaluation, additional education lessons will take place in units during
• emergency duty nurses’ meeting 2x60min
• student health care unit nurses’ meeting 1x90min
• junior physicians’ meeting 1x75min
• GPs’ meeting 1x60min
• general medicine department nurses’ meeting 2x30min
• PTs’ meeting 2x30min
• occupational health physicians’ meeting
• PTs’ meeting 1x60min
The nurse in charge of the emergency room is active in improving the implementation of the new care strategy.
|Rovaniemi||Low GP participation rate in education.|
Emergency department not part of the study.
Simultaneous relocation of primary health care facilities.
No occupational health service organization included the study.
|Previously complicated wide criteria for direct access to PT enormously reduces the possibility to use it. A notable criterion for direct access to physiotherapy during implementation process might be helpful.|
|EKSOTE||Simultaneous change in electronic medical record system increases requirements to adopt new working practices among professionals.||Some biopsychosocial oriented education for PTs had been held before this study, which is helpful for implementation.|
Mentoring will be arranged for PTs during implementation and re-evaluation.