Three success factors for continual improvement in healthcare: an analysis of the reports of improvement team members

Brandrud, Aleidis Skard; Schreiner, Ada; Hjortdahl, Per; Helljesen, Gro Sævil; Nyen, Bjørnar; Nelson, Eugene C.

doi:10.1136/bmjqs.2009.038604

Cited by 78 publications

(83 citation statements)

References 47 publications

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“…This is in accordance with Brandrud et al ,30 who found three success factors for continuous quality improvement; continuous and reliable information, involvement by all, and an infrastructure based on improvements in knowledge.…”

Section: Discussionsupporting

confidence: 92%

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Strengths and weaknesses of working with the Global Trigger Tool method for retrospective record review: focus group interviews with team members

et al. 2013

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ObjectivesThe aim was to describe the strengths and weaknesses, from team member perspectives, of working with the Global Trigger Tool (GTT) method of retrospective record review to identify adverse events causing patient harm.DesignA qualitative, descriptive approach with focus group interviews using content analysis.Setting5 Swedish hospitals in 2011.Participants5 GTT teams, with 5 physicians and 11 registered nurses.Intervention5 focus group interviews were carried out with the five teams. Interviews were taped and transcribed verbatim.Results8 categories emerged relating to the strengths and weaknesses of the GTT method. The categories found were: Usefulness of the GTT, Application of the GTT, Triggers, Preventability of harm, Team composition, Team tasks, Team members’ knowledge development and Documentation. Gradually, changes in the methodology were made by the teams, for example, the teams reported how the registered nurses divided up the charts into two sets, each being read respectively. The teams described the method as important and well functioning. Not only the most important, but also the most difficult, was the task of bringing the results back to the clinic. The teams found it easier to discuss findings at their own clinics.ConclusionsThe GTT method functions well for identifying adverse events and is strengthened by its adaptability to different specialties. However, small, gradual methodological changes together with continuingly developed expertise and adaption to looking at harm from a patient's perspective may contribute to large differences in assessment over time.

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Section: Discussionsupporting

confidence: 92%

“…This was also the team members’ view, considering that the most important function of the GTT method was the identification of AEs. In line with Brandrud et al ,30 they developed new knowledge that appeared to be useful locally.…”

Section: Discussionmentioning

confidence: 62%

Strengths and weaknesses of working with the Global Trigger Tool method for retrospective record review: focus group interviews with team members

et al. 2013

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“…Further research is needed to further unpack the "black box" of improvement. 12,13 Still, the 7 actions promoting QIC success that emerged in this study and similar in other studies 43,44 can support teams and leaders who are planning new QICs.…”

Section: Discussionmentioning

confidence: 50%

Collaboratively Improving Diabetes Care in Sweden Using a National Quality Register

Peterson

Guðbjörnsdóttir

Löfgren

et al. 2015

Quality Management in Health Care

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The teams reported improved patient outcomes significantly compared with the national average for systolic blood pressure and low-density lipoprotein levels. In contrast, glycated hemoglobin A1c levels deteriorated in the whole NDR population. Five themes of changes in practice were tested and implemented. Success factors included improved teamwork, with active use of register data, and testing new ideas and learning from others.

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“…These include: cross-site and local learning activities (e.g., staff education, PDSAs, team effectiveness) (31, 47, 53–55), local leadership support, sites’ ability to address common implementation barriers, expert support, ongoing data collection, and the visibility of local changes achieved through QI methods (3, 33, 47, 56–59). Additionally, there is a great need to continue to examine the costs associated with LCs and the incremental cost-benefit of using this approach, compared to traditional developer trainings and other QI methods.…”

Section: Discussionmentioning

confidence: 99%

A Literature Review of Learning Collaboratives in Mental Health Care: Used but Untested

Nadeem

Olin

Hill

et al. 2014

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Objective Policymakers have increasingly turned to Learning Collaboratives (LCs) as a strategy for improving usual care through the dissemination of evidence-based practices. The purpose of this review is to characterize the state of the evidence on LCs in mental health care. Methods A systematic search of major academic databases for peer-reviewed articles on LCs in mental health care generated 421 unique articles across a range of disciplines; 28 mental health articles were selected for full-text review, and 20 articles comprising 16 distinct studies met criteria for final inclusion. Articles were coded to identify the LC components reported, the focus of the research, and key findings. Results The majority of the articles included baseline to post-collaborative assessments of provider- or patient-level variables; there was only one study with a comparison condition. The LC targets ranged tremendously, from the use of a depression screener to implementation of evidence-based treatments. Fourteen crosscutting LC components (e.g., in-person learning sessions, phone meetings, data reporting, leadership involvement, training in QI methods) were identified from a systematic review of the extant literature on LCs. The LCs in this review reported including, on average, 7 components, most commonly in-person learning sessions, Plan-Do-Study-Act (PDSA) cycles, multidisciplinary QI teams, and data collection for QI. Conclusions LCs are being used widely in mental health care with minimal evidence of their effectiveness and unclear reporting on specific components. There is a great need for rigorous observational and controlled research studies on the impact of LCs on targeted provider- and patient-level outcomes.

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Three success factors for continual improvement in healthcare: an analysis of the reports of improvement team members

Cited by 78 publications

References 47 publications

Strengths and weaknesses of working with the Global Trigger Tool method for retrospective record review: focus group interviews with team members

Strengths and weaknesses of working with the Global Trigger Tool method for retrospective record review: focus group interviews with team members

Collaboratively Improving Diabetes Care in Sweden Using a National Quality Register

A Literature Review of Learning Collaboratives in Mental Health Care: Used but Untested

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