Methods of Capturing Process Outcomes in Quality Improvement Trials: A Systematic Review

Radisic, Gorjana; Perrelle, Lenore de la; Laver, Kate

doi:10.1097/jhq.0000000000000336

“…Often, process measures are focused on the clinician's compliance with an EBP. In a recent systematic review by Radisic and colleagues, 28 most process metrics were measured via retrospective review of the EHR (ie, documentation compliance with a practice). Although this is a relatively easy metric to obtain, documentation may not accurately reflect actual practice.…”

Section: Process Measurementioning

confidence: 99%

Call for Manuscripts

2023

Dimens Crit Care Nurs

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Background: Clinicians are often familiar with quality improvement (QI) and evidence-based practice (EBP) processes, which provides guidance into what evidence should be implemented; however, these processes do not address how to successfully implement evidence.Objective: Clinicians would benefit from a deeper understanding of implementation science, along with practical tools for how to use these principles in QI and EBP projects.Methods: We provide a brief background of the principles of implementation science, an overview of current implementation science models and a toolkit to facilitate choosing and using common implementation science strategies. In addition, the toolkit provides guidance for measuring the success of an implementation science project and a case study showing how implementation science strategies can be used successfully in clinical practice.Conclusions: Using an implementation science toolkit for designing, conducting, and evaluating a QI or EBP project improves the quality and generalizability of results.

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Association Between State‐Wide Cardiac Quality Improvement Program and Costs Following Intervention for Coronary Artery Disease

Wong,

Nelson,

Whitten

et al. 2024

Clinical Cardiology

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BackgroundSince 2010, all non‐VA hospitals performing cardiac surgeries and percutaneous interventions in Washington State have participated in the Cardiac Care Outcomes Assessment Program (COAP), a data‐driven, physician‐led collaborative quality improvement (QI) collaborative. Prior literature has demonstrated QI programs such as COAP can avert avoidable utilization such as hospital readmissions. However, it is unknown whether such improvements translate into economic benefits.HypothesisThis study compared downstream healthcare costs between patients undergoing cardiac interventions for coronary artery disease (CAD) at hospitals that were and were not participating in COAP.MethodsPost hoc analysis of Medicare administrative and claims data examined 2.5 million randomly selected deidentified beneficiaries receiving a percutaneous coronary intervention or coronary artery bypass grafting between 2013 and 2020. Total costs were defined as all reimbursements paid by Medicare for up to 5 years following cardiac intervention. Because all non‐VA hospitals in Washington State participated in COAP, we compared respective groups of patients receiving intervention in Washington State with all non‐Washington states, adjusting for patient demographics and comorbidity. To model costs, we applied a multipart estimator, which distinguishes the impact of QI program participation due to survival and utilization while accounting for censoring.ResultsTotal 5‐year downstream costs were $3861 lower (95% confidence interval [CI] = $1794 to $5741) among patients receiving cardiac intervention at COAP‐exposed hospitals. Lower costs were largely driven by lower utilization during calendar quarters where death was not observed.ConclusionsParticipation in this state‐wide cardiac quality improvement program was associated with economic benefits in patients receiving intervention for CAD.

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Implementation Science Toolkit for Clinicians

Reynolds

¹

,

Granger

²

2023

Dimens Crit Care Nurs

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Background: Clinicians are often familiar with quality improvement (QI) and evidence-based practice (EBP) processes, which provides guidance into what evidence should be implemented; however, these processes do not address how to successfully implement evidence.Objective: Clinicians would benefit from a deeper understanding of implementation science, along with practical tools for how to use these principles in QI and EBP projects.Methods: We provide a brief background of the principles of implementation science, an overview of current implementation science models and a toolkit to facilitate choosing and using common implementation science strategies. In addition, the toolkit provides guidance for measuring the success of an implementation science project and a case study showing how implementation science strategies can be used successfully in clinical practice.Conclusions: Using an implementation science toolkit for designing, conducting, and evaluating a QI or EBP project improves the quality and generalizability of results.

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Methods of Capturing Process Outcomes in Quality Improvement Trials: A Systematic Review

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 3 publications

References 43 publications

Call for Manuscripts

Call for Manuscripts

Association Between State‐Wide Cardiac Quality Improvement Program and Costs Following Intervention for Coronary Artery Disease

Implementation Science Toolkit for Clinicians

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