Conceptualizing and assessing improvement capability: a review

Furnival, Joy; Boaden, Ruth; Walshe, Kieran

doi:10.1093/intqhc/mzx088

Cited by 15 publications

(20 citation statements)

References 44 publications

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“…The reported outcomes on the organisations are interesting since healthcare improvement capability is an area of much current discussion—it is questioned whether it is possible to increase organisational improvement capability through courses in QI; see for example refs 7 35 36. In a paper by Babich et al 8 it is concluded that hospitals focusing on either projects or staff training had limited value compared with organisations strengthening their organisational systems, structures or processes aimed at improvement efforts.…”

Section: Discussionmentioning

confidence: 99%

Fourteen years of quality improvement education in healthcare: a utilisation-focused evaluation using concept mapping

et al. 2019

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BackgroundThe need for training in quality improvement for healthcare staff is well acknowledged, but long-term outcomes of such training are hard to evaluate. Behaviour change, improved organisational performance and results are sought for, but these variables are complex, multifactorial and difficult to assess.AimThe purpose of this article is to explore the personal and organisational outcomes identified by participants over 14 years of university-led QI courses for healthcare professionals.MethodInspired by the Kirkpatrick model for evaluation, we used concept mapping, a structured mixed method that allows for richness of data to be captured and visualised by inviting stakeholders throughout the process. In total, 331 previous course participants were included in the study by responding to two prompts, and 19 stakeholders taking part in the analysis process by doing the sorting.ResultTwo maps, one for personal outcomes and one for organisational outcomes, show clusters of the responses from previous course participants and how the outcomes relate to each other in meta-clusters. Both maps show possible long-term outcomes described by the previous course participants.ConclusionThe results of this study indicate that it is possible that training in quality improvement with a strong experiential pedagogical approach fosters a long-term improvement capability for the course participants and, even more important, a long-term improvement capability (and increased improvement skill) in their respective organisations.

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Section: Discussionmentioning

confidence: 99%

Fourteen years of quality improvement education in healthcare: a utilisation-focused evaluation using concept mapping

et al. 2019

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“…For example—the Health Foundation’s QI evidence scan,48 and Walshe20 both review improvement methodologies using a variety of different terms. We both used a variety of different terms for ‘QI’ within searches to capture QI literature 21 29. We used free-text key words to account for the problem that phrases such as ‘quality improvement’ and ‘continuous improvement’ are sometimes used synonymously.…”

Section: Challenges Of Conducting a Literature Review Systematically mentioning

confidence: 99%

“…Similarly, literature review revealed no accepted definition. Therefore, Furnival et al (2017)29 used Whittemore and Knafl’s integrative review method50 which allows for several perspectives of a topic to be used. Improvement capability was defined as: ‘the organisational ability to intentionally and systematically use improvement approaches, methods and practices, to change processes and products/services to generate improved performance.’29…”

Section: Challenges Of Conducting a Literature Review Systematically mentioning

confidence: 99%

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Identifying and resolving the frustrations of reviewing the improvement literature: The experiences of two improvement researchers

2019

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Background and aimsSummarising quality improvement (QI) research through systematic literature review has great potential to improve patient care. However, heterogeneous terminology, poor definition of QI concepts and overlap with other scientific fields can make it hard to identify and extract data from relevant literature. This report examines the compromises and pragmatic decisions that undertaking literature review in the field of QI requires and the authors propose recommendations for literature review authors in similar fields.MethodsTwo authors (EJ and JF) provide a reflective account of their experiences of conducting a systematic literature review in the field of QI. They draw on wider literature to justify the decisions they made and propose recommendations to improve the literature review process. A third collaborator, (WC) co-created the paper challenging author’s EJ and JF views and perceptions of the problems and solutions of conducting a review of literature in QI.ResultsTwo main challenges were identified when conducting a review in QI. These were defining QI and selecting QI studies. Strategies to overcome these problems include: select a multi-disciplinary authorship team; review the literature to identify published QI search strategies, QI definitions and QI taxonomies; Contact experts in related fields to clarify whether a paper meets inclusion criteria; keep a reflective account of decision making; submit the protocol to a peer reviewed journal for publication.ConclusionsThe QI community should work together as a whole to create a scientific field with a shared vision of QI to enable accurate identification of QI literature. Our recommendations could be helpful for systematic reviewers wishing to evaluate complex interventions in both QI and related fields.

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“…However, there is a substantial relevant literature, in healthcare and other sectors, on what has been termed improvement capability, defined for the purposes of this paper as ‘the organisational ability to intentionally and systematically use improvement approaches, methods and practices, to change processes and products/services to generate improved performance’ [10] (p. 5). This definition comes from a recent integrative review of improvement capability by Furnival et al which highlighted the absence of empirically tested and validated frameworks for assessing improvement capability and identified a number of competing definitions and 70 different assessment tools or frameworks with somewhat divergent underlying theoretical models, constructs and measurement items.…”

Section: Introductionmentioning

confidence: 99%

Improvement capability and performance: a qualitative study of maternity services providers in the UK

Darley

Walshe

Boaden³

et al. 2018

International Journal for Quality in Health Care

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Objective: We explore variations in service performance and quality improvement across healthcare organisations using the concept of improvement capability. We draw upon a theoretically informed framework comprising eight dimensions of improvement capability, firstly to describe and compare quality improvement within healthcare organisations and, secondly to investigate the interactions between organisational performance and improvement capability. Design: A multiple qualitative case study using semi-structured interviews guided by the improvement capability framework. Setting: Five National Health Service maternity services sites across the UK. We focused on maternity services due to high levels of variation in quality and the availability of performance metrics which enabled us to select organisations from across the performance spectrum. Participants: About 52 hospital staff members across the five case studies in positions relevant to the research questions, including midwives, obstetricians and clinical managers/leaders. Main Outcome Measure: A qualitative analysis of narratives of quality improvement and performance in the five case studies, using the improvement capability framework as an analytic device to compare and contrast cases. Results: The improvement capability framework has utility in analysing quality improvement within and across organisations. Qualitative differences in the configurations of improvement capability were identified across all providers but were particularly striking between higher and lower performing organisations. Conclusions: The improvement capability framework is a useful tool for healthcare organisations to assess, manage and develop their own improvement capabilities. We identified an interaction between performance and improvement capability; higher performing organisations appeared to have more developed improvement capabilities, though the meaning of this relationship requires further research.

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Conceptualizing and assessing improvement capability: a review

Cited by 15 publications

References 44 publications

Fourteen years of quality improvement education in healthcare: a utilisation-focused evaluation using concept mapping

Fourteen years of quality improvement education in healthcare: a utilisation-focused evaluation using concept mapping

Identifying and resolving the frustrations of reviewing the improvement literature: The experiences of two improvement researchers

Improvement capability and performance: a qualitative study of maternity services providers in the UK

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