Development and Validation of the CPO Scale, a New Instrument for Evaluation of Health Care Improvement Efforts

Brandrud, Aleidis Skard; Haldorsen, Gro Sævil Helljesen; Nyen, Bjørnar; Vårdal, Mari; Nelson, Eugene C.; Sandvik, Leiv; Hjortdahl, Per

doi:10.1097/qmh.0000000000000065

Cited by 3 publications

(21 citation statements)

References 57 publications

(55 reference statements)

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“…The present study highlights the importance of using measurement to understand and reflect on the variations in current practice, and to monitor the target process continually to maintain motivation for change. Learning from the final reports of the improvement projects, the sub study indicate that successful results are connected to a clear linkage between vision, aims and proper measurements, clear and understandable improvement efforts, and the ability to communicated this all to others in an understandable way [ 32 ]. Our findings support the findings of others indicating that by measuring and monitoring variation and change with control charts, it is easier to understand and manage performance from week-to-week, communicate progress, and motivate colleagues to sustain the improvements [ 43 – 48 ].…”

Section: Discussionmentioning

confidence: 99%

“…Third , we analyzed the data by comparing the reported conditions for improvement in the organizations of the successful projects versus the other (comparator) projects. We already knew the success level of the 189 projects from the validation of a Change Process and Outcome Scale instrument which was published in 2015 (Sub study II) [ 32 ].…”

Section: Methodsmentioning

confidence: 99%

“…The second sub study was published in 2015 [ 32 ]. Seven improvement experts from different healthcare professions alternated in participating in a four-person review team.…”

Section: Methodsmentioning

confidence: 99%

“…Process and outcome evaluation by improvement experts and improvement teams can illuminate the strategies and processes responsible for the improvement of the target process. In so doing, the process and outcome evaluation from sub study II [ 32 ], makes a relevant and important contribution to the development of potentially successful strategies to make positive changes in patient care [ 12 ].…”

Section: Methodological Considerationsmentioning

confidence: 99%

“…Systematic reviews and single studies of quality improvement efforts that are reported, indicate that a systematic and knowledge based approach is not enough to succeed without the presence of certain conditions for improvement, also described as context factors [ 13 , 14 , 16 , 31 ]. To meet these challenges, additional improvement approaches, including instruments for evaluating the underlying conditions for improvement, have been described [ 12 , 17 , 32 ]. In 2004 a systematic review recommended further research on factors that tend to produce adoptable changes in healthcare organizations [ 33 ].…”

Section: Introductionmentioning

confidence: 99%

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Domains associated with successful quality improvement in healthcare – a nationwide case study

Brandrud

Nyen

Hjortdahl

et al. 2017

BMC Health Serv Res

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BackgroundThere is a distinct difference between what we know and what we do in healthcare: a gap that is impairing the quality of the care and increasing the costs. Quality improvement efforts have been made worldwide by learning collaboratives, based on recognized continual improvement theory with limited scientific evidence. The present study of 132 quality improvement projects in Norway explores the conditions for improvement from the perspectives of the frontline healthcare professionals, and evaluates the effectiveness of the continual improvement method.MethodsAn instrument with 25 questions was developed on prior focus group interviews with improvement project members who identified features that may promote or inhibit improvement. The questionnaire was sent to 189 improvement projects initiated by the Norwegian Medical Association, and responded by 70% (132) of the improvement teams. A sub study of their final reports by a validated instrument, made us able to identify the successful projects and compare their assessments with the assessments of the other projects. A factor analysis with Varimax rotation of the 25 questions identified five domains. A multivariate regression analysis was used to evaluate the association with successful quality improvements.ResultsTwo of the five domains were associated with success: Measurement and Guidance (p = 0.011), and Professional environment (p = 0.015). The organizational leadership domain was not associated with successful quality improvements (p = 0.26).ConclusionOur findings suggest that quality improvement projects with good guidance and focus on measurement for improvement have increased likelihood of success. The variables in these two domains are aligned with improvement theory and confirm the effectiveness of the continual improvement method provided by the learning collaborative. High performing professional environments successfully engaged in patient-centered quality improvement if they had access to: (a) knowledge of best practice provided by professional subject matter experts, (b) knowledge of current practice provided by simple measurement methods, assisted by (c) improvement knowledge experts who provided useful guidance on measurement, and made the team able to organize the improvement efforts well in spite of the difficult resource situation (time and personnel). Our findings may be used by healthcare organizations to develop effective infrastructure to support improvement and to create the conditions for making quality and safety improvement a part of everyone’s job.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2454-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…The second sub study was published in 2015 [ 32 ]. Seven improvement experts from different healthcare professions alternated in participating in a four-person review team.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodological Considerationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Domains associated with successful quality improvement in healthcare – a nationwide case study

Brandrud

Nyen

Hjortdahl

et al. 2017

BMC Health Serv Res

Self Cite

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Prioritising recommendations following analyses of adverse events in healthcare: a systematic review

2020

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PurposeThe purpose of this systematic review was to identify an appropriate method—a user-friendly and validated method—that prioritises recommendations following analyses of adverse events (AEs) based on objective features.Data sourcesThe electronic databases PubMed/MEDLINE, Embase (Ovid), Cochrane Library, PsycINFO (Ovid) and ERIC (Ovid) were searched.Study selectionStudies were considered eligible when reporting on methods to prioritise recommendations.Data extractionTwo teams of reviewers performed the data extraction which was defined prior to this phase.Results of data synthesisEleven methods were identified that are designed to prioritise recommendations. After completing the data extraction, none of the methods met all the predefined criteria. Nine methods were considered user-friendly. One study validated the developed method. Five methods prioritised recommendations based on objective features, not affected by personal opinion or knowledge and expected to be reproducible by different users.ConclusionThere are several methods available to prioritise recommendations following analyses of AEs. All these methods can be used to discuss and select recommendations for implementation. None of the methods is a user-friendly and validated method that prioritises recommendations based on objective features. Although there are possibilities to further improve their features, the ‘Typology of safety functions’ by de Dianous and Fiévez, and the ‘Hierarchy of hazard controls’ by McCaughan have the most potential to select high-quality recommendations as they have only a few clearly defined categories in a well-arranged ordinal sequence.

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Restorative just culture significantly improves stakeholder inclusion, second victim experiences and quality of recommendations in incident responses

Turner

Sveticic²,

Grice³

et al. 2022

JHA

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Objective: Matching safety and quality improvements to the complexity of healthcare, Gold Coast Mental Health and Specialist Services implemented a new response to clinical incidents: the Gold Coast Clinical Incident Response Framework (GC-CIRF). It utilises a Restorative Just Culture (RJC) framework and Safety II principles. This paper evaluates its impact.Methods: Staff surveys measured perceptions of just culture and second victim experiences. Quality of recommendations were compared before and after implementation. For the 19 incidents that occurred after the implementation of GC-CIRF, audits of the review processes were undertaken, measuring several components.Results: Results show significant improvement in staff perceptions of just culture and second victim experiences. Review of incident review data showed several shifts in line with Safety II and RJC. The process audit demonstrated inclusion of a broad range of stakeholders, and significant improvements in the quality and strength of recommendations.Conclusions: Embedding RJC and Safety II concepts into the incident review process is associated with improved measures of culture and review outputs. The integration of Safety II concepts and support of cultural shifts will require further work and committed leadership at all levels.

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Development and Validation of the CPO Scale, a New Instrument for Evaluation of Health Care Improvement Efforts

Abstract: The CPO scale shows good internal consistency, reliability, and validity for evaluating the success of quality improvement initiatives.

Cited by 3 publications

References 57 publications

Domains associated with successful quality improvement in healthcare – a nationwide case study

Domains associated with successful quality improvement in healthcare – a nationwide case study

Prioritising recommendations following analyses of adverse events in healthcare: a systematic review

Restorative just culture significantly improves stakeholder inclusion, second victim experiences and quality of recommendations in incident responses

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