Clinical Quality Improvement and Quality Improvement Research

Mormer, Elaine; Stevans, Joel M.

doi:10.1044/2018_pers-st-2018-0003

Cited by 11 publications

(11 citation statements)

References 31 publications

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“…Given that improvement is an inherently contextdependent social process, taking place in real-world clinical settings [20], the influence of context is highly significant, and so stripping out contextual factors from improvement research limits the usefulness and generalisability of findings [21]. Research studies that factor out context are not always able to articulate the crucial 'how' and 'why' around the success or failure of QI projects within complex healthcare systems, and as such, are not able to predict whether improvement efforts will easily transfer to other settings.…”

Section: Why Is Context Important To Quality Improvement?mentioning

confidence: 99%

The influence of contextual factors on healthcare quality improvement initiatives: a realist review

et al. 2020

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Background: Recognising the influence of context and the context-sensitive nature of quality improvement (QI) interventions is crucial to implementing effective improvements and successfully replicating them in new settings, yet context is still poorly understood. To address this challenge, it is necessary to capture generalisable knowledge, first to understand which aspects of context are most important to QI and why, and secondly, to explore how these factors can be managed to support healthcare improvement, in terms of implementing successful improvement initiatives, achieving sustainability and scaling interventions. The research question was how and why does context influence quality improvement initiatives in healthcare? Methods: A realist review explored the contextual conditions that influence healthcare improvement. Realist methodology integrates theoretical understanding and stakeholder input with empirical research findings. The review aimed to identify and understand the role of context during the improvement cycle, i.e. planning, implementation, sustainability and transferability; and distil new knowledge to inform the design and development of context-sensitive QI initiatives. We developed a preliminary theory of the influence of context to arrive at a conceptual and theoretical framework. Results: Thirty-five studies were included in the review, demonstrating the interaction of key contextual factors across healthcare system levels during the improvement cycle. An evidence-based explanatory theoretical model is proposed to illustrate the interaction between contextual factors, system levels (macro, meso, micro) and the stages of the improvement journey. Findings indicate that the consideration of these contextual factors would enhance the design and delivery of improvement initiatives, across a range of improvement settings. Conclusions: This is the first realist review of context in QI and contributes to a deeper understanding of how context influences quality improvement initiatives. The distillation of key contextual factors offers the potential to inform the design and development of context-sensitive interventions to enhance improvement initiatives and address the challenge of spread and sustainability. Future research should explore the application of our conceptual model to enhance improvement-planning processes.

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Section: Why Is Context Important To Quality Improvement?mentioning

confidence: 99%

The influence of contextual factors on healthcare quality improvement initiatives: a realist review

et al. 2020

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“…After collecting baseline data, micro-and macrolevel recommendations for change included changing the wording used during bedside nursing assessments and comparing self-reported patient hearing status data with audiometric thresholds. Results of this ongoing project resulted in increased referrals for people with hearing loss (e.g., penetration), increased use of personal amplifiers (e.g., adoption), and increased awareness of audiology services overall (Mormer & Stevans, 2019). Thus, projects such as this suggest that a systematic approach to the adoption of a new hospital protocol or curriculum intervention for a school system would benefit from a similar kind of systematic, iterative approach used when planning research projects.…”

Section: Potential Clinical Implicationsmentioning

confidence: 99%

Planning for Implementation Science in Clinical Practice Research: An Augmentative and Alternative Communication Example

Binger

Douglas

Kent-Walsh

2022

Am J Speech Lang Pathol

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Purpose Most evidence-based clinical research findings in communication sciences and disorders never achieve full implementation by practicing clinicians. To address this almost universal problem, this tutorial focuses on the initial planning steps of including implementation methodologies as part of clinical practice research programs. Integrating the principles and methodologies of implementation science can shift the current reality, leading to better uptake of evidence-based interventions. Method A step-by-step approach to integrating implementation science into new or existing research projects is provided, including the construction of a logic model, the selection of an implementation framework, and the selection of research methodologies. A detailed example of an augmentative and alternative communication research program is provided to illustrate the process. Conclusions Readily available online tools can help researchers start the process of integrating implementation science into clinical practice research, and existing frameworks can assist with developing and guiding research programs to ensure maximal impact. If the ultimate goal is to improve the daily lives of individuals with communication disorders through the use of evidence-based practices, clinical practice researchers must integrate these approaches into their research programs.

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“…Related to Quality and Quality Standard [14], which will provide an overview of the extent to which must be done and especially services that meet the minimum and optimal standards; 2. Related to procedures [15] that must be carried out and the most important thing is related to patient safety, because it will allow services that save the patient, it will include simultaneously saving doctors and hospitals;…”

Section: Clinical Pathway For Services Quality Improvement 21 Clinica...mentioning

confidence: 99%

Clinical Pathway for Improving Quality Service and Cost Containtment in Hospital

Sabarguna¹

2022

Contemporary Issues in Information Systems - A Global Perspective

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The explanation begins with the Clinical Pathway in Hospital which describes how the Clinical Pathway is used in relation to 2 things: Components-Linkages and Step-Problems-Optimal Solution, followed by Linkages Clinical Pathway with Quality Improvement and Cost Containment, which describes the relationship of each. Followed by the Clinical Pathway for Service Quality: which consists of: (1) Clinical Pathway for Service Quality, (2) Patient Safety for Service Quality Improvement, (3) The role of alogarithm, thereby clarifying the form of clinical pathways in quality improvement efforts that ensure service improvement by still maintain the quality that is maintained during the cost containment. The Clinical Pathway in Cost Containment describes the roles of: (1) Link of Components, (2) Procedure, (3) Unit Cost, so that cost containment efforts can be made in the form of cost containment optimally while maintaining quality does not need to decrease. Clinical Pathway in New Era is a newly developed algorithm related to current and future conditions. This is related to: (1) New Era in Pandemic Covid-19, (2) Clinical Pathway in Non Curative Service, (3) Clinical Pathway in Technology Services, (4) Clinical Pathway in Technological Rerelated while continuing to carry out quality improvement and cost containment simultaneously. Concluton: clinical pathway in hospital can be used as a system for Quality Improvement and Cost Containment, related to New Era in Pandemic Covid-19, Non Curative Service, Technology Services and Technological Rerelated.

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Clinical Quality Improvement and Quality Improvement Research

Cited by 11 publications

References 31 publications

The influence of contextual factors on healthcare quality improvement initiatives: a realist review

The influence of contextual factors on healthcare quality improvement initiatives: a realist review

Planning for Implementation Science in Clinical Practice Research: An Augmentative and Alternative Communication Example

Clinical Pathway for Improving Quality Service and Cost Containtment in Hospital

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