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Table 7 Round two results: rating of factors in terms of importance within each category in shaping the extent to which decommissioning is implemented as planned

From: Disentangling rhetoric and reality: an international Delphi study of factors and processes that facilitate the successful implementation of decisions to decommission healthcare services

Factor Very low importance Little importance High importance Very high importance Do not know
Change management and implementation strategy
Strength of executive leadership 0 0 7.4 92.6 0
Strength of clinical leadership 0 3.7 14.8 74.1 7.4
Quality of communication 0 3.7 33.3 63.0 0
Clarity of specific aims and objectives at start 0 3.7 48.1 48.1 0
Extent of cultural and behavioural change 0 7.4 51.9 40.7 0
Attention throughout to human aspects of process of change 0 11.5 46.2 42.3 0
Quality of project management 0 11.1 48.1 40.7 0
Availability of resources to support decision-making and implementation processes 0 14.8 48.1 33.3 3.7
Quality of strategic planning 0 11.1 63.0 25.9 0
Training and preparation of staff 0 18.5 63.0 18.5 0
Clarity of incentives and levers to support change 0 22.2 59.3 18.5 0
Complexity of decommissioning programme 0 29.6 59.3 11.1 0
Pace of change 3.7 40.7 51.9 0 3.7
Evidence and information
Demonstrable benefits 0 0 37.0 63.0 0
Clarity of evidence/data to support business case, ongoing monitoring and impact assessment 0 0 63.0 37.0 0
Clarity around new patient pathways 0 14.8 63.0 18.5 3.7
Review/evaluation of process 3.7 11.1 59.3 25.9 0
Availability of alternative services 0 25.9 51.9 22.2 0
Extent of adoption elsewhere of new intervention/service 0 33.3 48.1 18.5 0
Relationships and political dimensions
Clarity of rationale/case for change 0 0 29.6 70.4 0
Nature and extent of clinician engagement/involvement 0 7.4 33.3 59.3 0
Level of political support 0 14.8 29.6 55.6 0
Transparency of decision-making process 0 7.4 63.0 29.6 0
Nature and extent of patient/public engagement/involvement 0 14.8 51.9 29.6 3.7
Quality of partnership working with relevant agencies 0 7.7 76.9 11.5 3.8
Extent to which challenges vested interests 0 23.1 46.2 30.8 0
Nature and extent of media coverage 0 25.9 51.9 18.5 3.7
Stability within the local health economy during transition 3.7 18.5 66.7 11.1 0
Reputation of existing providers 0 33.3 55.6 3.7 7.4
Meets community expectations 0 37.0 51.9 7.4 3.7
  1. (% responses) (in descending order of importance within each category).