Table 2

Stakeholder positions concerning the task substitution of person and setting before and after GFU establishment
Theory 1: closed window Theory 2: unclear returns on investments Theory 3: power position - level interest
Before GFU establishment Glaucoma Specialists High workload, increasing demand for glaucoma care. Workload release, decreasing the waiting list, more challenging work. High power position and high interest for a successful task substitution.
Management REH Increased competition on volume. Increase in volume of (new) patients. Medium power position and high interest for a successful task substitution.
Primary care optometrists Competition with optical chains, chance to professionalize. Increase in volume of (new) patients. Low power position and high interest for a successful task substitution.
Patients Were not involved at the start. More flexible appointments and more time per appointment. Medium power position and medium interest for a successful task substitution.
Dutch Health Care Authority / Health insurers Were not involved at the start. Care would possibly become less expensive High power position and unclear interest for a successful task substitution.
GFU employees Were not involved at the start. Low power position and low interest for a successful task substitution.
After GFU establishment Glaucoma Specialists Release of workload due to GFU. The establishment of the GFU already fulfilled their goals. Reduction of interest for a successful task substitution.
Management REH Better alternative was found through cooperation with optical chain. Disappointing increase in volume due to cooperation with OCR. Alternative was found. Reduction of interest for a successful task substitution.
Primary care optometrists Cooperation remained on the same level. Increase in new patients differed among optometrists. Reduction of chance to strengthen relationship with glaucoma specialists
Patients GFU resulted in more time per patient, and care in a familiar setting. Reduction of interest for a successful task substitution.
NZA / Health insurers Quality of care in GFU was good. No changes in interest due to establishment of GFU.
GFU employees Improved relationship with glaucoma specialists and more satisfying work. The consequences of starting task substitution for the GFU were unclear. Increase of power position.

Holtzer-Goor et al.

Holtzer-Goor et al. Implementation Science 2013 8:14   doi:10.1186/1748-5908-8-14

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