Lessons in quality improvement

Jones, Bryan D.; Chatfield, Cat

doi:10.1136/bmj.o475

Cited by 4 publications

(1 citation statement)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Measurement and feedback is an essential component of a learning health system, and therefore it is encouraging that the findings of this study have incorporated all competencies in the review. Furthermore, the 11 considerations for future design and implementation of measurement feedback systems highlighted in this manuscript are aligned with literature related to patient prioritisation of measurement focus,34 quality improvement culture, collaboration and leadership,35 36 health professional knowledge and skills37 and the use of dashboards in feedback 31 38 39. This study articulates complementary considerations for measurement feedback systems to the literature, including financial investment in technological infrastructure and interdisciplinary human resources, translation support roles for quality improvement and the need to work with EMR vendors to support use of routinely collected data.…”

Section: Discussionmentioning

confidence: 65%

Qualitative study of international key informants’ perspectives on the current and future state of healthcare quality measurement and feedback

et al. 2023

View full text Add to dashboard Cite

ObjectivesThe aim of this study is to explore the current and future state of quality measurement and feedback and identify factors influencing measurement feedback systems, including the barriers and enablers to their effective design, implementation, use and translation into quality improvement.DesignThis qualitative study used semistructured interviews with key informants. A deductive framework analysis was conducted to code transcripts to the Theoretical Domains Framework (TDF). An inductive analysis was used to produce subthemes and belief statements within each TDF domain.SettingAll interviews were conducted by videoconference and audio-recorded.ParticipantsKey informants were purposively sampled experts in quality measurement and feedback, including clinical (n=5), government (n=5), research (n=4) and health service leaders (n=3) from Australia (n=7), the USA (n=4), the UK (n=2), Canada (n=2) and Sweden (n=2).ResultsA total of 17 key informants participated in the study. The interview length ranged from 48 to 66 min. 12 theoretical domains populated by 38 subthemes were identified as relevant to measurement feedback systems. The most populous domains includedenvironmental context and resources,memory, attention and decision-making, andsocial influences. The most populous subthemes included ‘quality improvement culture’, ‘financial and human resource support’ and ‘patient-centred measurement’. There were minimal conflicting beliefs outside of ‘data quality and completeness’. Conflicting beliefs in these subthemes were predominantly between government and clinical leaders.ConclusionsMultiple factors were found to influence measurement feedback systems and future considerations are presented within this manuscript. The barriers and enablers that impact these systems are complex. While there are some clear modifiable factors in the design of measurement and feedback processes, influential factors described by key informants were largely socioenvironmental. Evidence-based design and implementation, coupled with a deeper understanding of the implementation context, may lead to enhanced quality measurement feedback systems and ultimately improved care delivery and patient outcomes.

show abstract

Section: Discussionmentioning

confidence: 65%

Qualitative study of international key informants’ perspectives on the current and future state of healthcare quality measurement and feedback

et al. 2023

View full text Add to dashboard Cite

show abstract

Factors Affecting Health Research Utilization Among Health Professionals in Nigeria

Avwerhota,

Daniel,

Avwerhota

et al. 2024

AJHR

View full text Add to dashboard Cite

The utilization of health research in clinical practice is hindered by individual, organizational, and systemic barriers, including insufficient research literacy and unsupportive organizational cultures. Enhancing research literacy, fostering supportive environments, and implementing evidence-based policies are crucial for bridging the gap between research and practice, ultimately improving patient outcomes. This study investigates the factors affecting health research utilization among health professionals in Nigeria, an essential aspect for advancing healthcare systems and patient outcomes. Utilizing a cross-sectional descriptive design, data were collected via an online survey distributed to public health professionals and policymakers. The survey explored demographics, research utilization, dissemination effectiveness, barriers, and recommendations for improvement. Key findings indicate significant demographic disparities, with a higher proportion of younger and non-public health degree holders reporting unused research findings. The study identified major barriers, including inadequate communication, poor dissemination practices, and lack of access to research findings. Despite 87.6% of respondents conducting potentially impactful research, only 13.6% reported actual utilization of their findings. The recommendations for improvement emphasized the role of knowledge brokers, fostering research-attuned and decision-relevant cultures, enhancing communication and interaction between researchers and users, and building capacity among all stakeholders. Additionally, establishing effective dissemination systems, securing funding, and promoting international collaboration were highlighted as critical strategies. The study underscores the necessity of addressing structural, cultural, and communicative barriers to improve the practical application of health research in Nigeria, aligning with global trends and literature advocating for a multifaceted approach to enhance health outcomes.

show abstract

Co-design of a nurse handover tool to optimise infection control and antimicrobial stewardship in a low resource setting intensive care unit: A nurse led collaboration

Bonaconsa,

van den Bergh,

Charani

et al. 2024

Wellcome Open Res

View full text Add to dashboard Cite

Background The quality of intensive care unit (ICU) nursing handover impacts patient safety, including infection prevention and control (IPC) and antimicrobial stewardship (AMS) practices. We report a co-designed quality improvement study using a visual, structured nurse handover tool in a low resource setting. Methods The study was conducted with clinical nurses in an 8-bed medical ICU at a tertiary hospital in South Africa. Using a participatory action research (PAR) framework and visual participatory methods, the handover tool development had three phases: data collection, journal club, and co-design. To engage busy nurses and create real-time discussions and input, 7-minute focussed sessions in the ICUs using large-scale graphics to facilitate were used. Qualitative data were thematically analysed. Results Between September – October 2022, baseline data were collected from 16 handovers (46 patient discussions over 4 hours). The tool was co-designed through 18 contact sessions involving 31 nurses (April–June 2023). Variation was observed in patterns of handover structure (sequence of what was presented) and content (type and the level of detail of information provided). An evidence-based visual tool was co-designed to identify and manage key patient care risk factors. The tool included a structured section to report on IPC and AMS. Nurses reported the visual prompts to be beneficial to ensuring consistent inclusion of critical information in handovers. Conclusions An innovative approach involving ICU nurses in co-designing a visual handover tool resulted in a structured method for systematically reporting patient care risk factors, body systems, IPC, and AMS. Implementation and dissemination in this unit, and expansion to other units, is underway to promote sustainable change in nursing clinical practices.

show abstract

Lessons in quality improvement

Cited by 4 publications

References 17 publications

Qualitative study of international key informants’ perspectives on the current and future state of healthcare quality measurement and feedback

Qualitative study of international key informants’ perspectives on the current and future state of healthcare quality measurement and feedback

Factors Affecting Health Research Utilization Among Health Professionals in Nigeria

Co-design of a nurse handover tool to optimise infection control and antimicrobial stewardship in a low resource setting intensive care unit: A nurse led collaboration

Contact Info

Product

Resources

About