Developing a tool to measure enactment of complex quality improvement interventions in healthcare
Quality improvement (QI) projects are common in healthcare settings and often involve interdisciplinary teams working together towards a common goal. Many interventions and programmes have been introduced through research to convey QI skills and knowledge to healthcare workers, however, a few studie...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-02-01
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| Series: | BMJ Open Quality |
| Online Access: | https://bmjopenquality.bmj.com/content/12/1/e002027.full |
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| author | Liane R Ginsburg Whitney Berta Yuting Song Matthias Hoben Adrian Wagg Carole A Estabrooks Malcolm Doupe Lauren MacEachern Jennifer A Knopp-Sihota Lisa Cranley |
| author_facet | Liane R Ginsburg Whitney Berta Yuting Song Matthias Hoben Adrian Wagg Carole A Estabrooks Malcolm Doupe Lauren MacEachern Jennifer A Knopp-Sihota Lisa Cranley |
| author_sort | Liane R Ginsburg |
| collection | DOAJ |
| description | Quality improvement (QI) projects are common in healthcare settings and often involve interdisciplinary teams working together towards a common goal. Many interventions and programmes have been introduced through research to convey QI skills and knowledge to healthcare workers, however, a few studies have attempted to differentiate between what individuals ‘learn’ or ‘know’ versus their capacity to apply their learnings in complex healthcare settings. Understanding and differentiating between delivery, receipt, and enactment of QI skills and knowledge is important because while enactment alone does not guarantee desired QI outcomes, it might be reasonably assumed that ‘better enactment’ is likely to lead to better outcomes. This paper describes the development, application and validation of a tool to measure enactment of core QI skills and knowledge of a complex QI intervention in a healthcare setting. Based on the Institute for Healthcare Improvement’s Model for Improvement, existing QI assessment tools, literature on enactment fidelity and our research protocols, 10 indicators related to core QI skills and knowledge were determined. Definitions and assessment criteria were tested and refined in five iterative cycles. Qualitative data from four QI teams in long-term care homes were used to test and validate the tool. The final measurement tool contains 10 QI indicators and a five-point scale. Inter-rater reliability ranged from good to excellent. Usability and acceptability among raters were considered high. This measurement tool assists in identifying strengths and weaknesses of a QI team and allows for targeted feedback on core QI components. The indicators developed in our tool and the approach to tool development may be useful in other health related contexts where similar data are collected. |
| format | Article |
| id | doaj-art-96e402666e994827b18378aee971139b |
| institution | Kabale University |
| issn | 2399-6641 |
| language | English |
| publishDate | 2023-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Quality |
| spelling | doaj-art-96e402666e994827b18378aee971139b2024-12-31T15:50:08ZengBMJ Publishing GroupBMJ Open Quality2399-66412023-02-0112110.1136/bmjoq-2022-002027Developing a tool to measure enactment of complex quality improvement interventions in healthcareLiane R Ginsburg0Whitney Berta1Yuting Song2Matthias Hoben3Adrian Wagg4Carole A Estabrooks5Malcolm Doupe6Lauren MacEachern7Jennifer A Knopp-Sihota8Lisa Cranley9Health Policy & Management, York University, Toronto, Ontario, CanadaUniversity of Toronto Institute of Health Policy, Management and Evaluation, Toronto, Ontario, Canada1 School of Nursing, Qingdao University, Qingdao, ChinaFaculty of Health, School of Health Policy & Management, York University, Toronto, Ontario, CanadaDepartment of Medicine, University of Alberta, Edmonton, Alberta, CanadaFaculty of Nursing, University of Alberta, Edmonton, Alberta, CanadaCommunity Health Sciences, University of Manitoba Faculty of Health Sciences, Winnipeg, Manitoba, CanadaUniversity of Toronto, Toronto, CanadaFaculty of Health Disciplines, Athabasca University, Athabasca, Alberta, CanadaLawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, CanadaQuality improvement (QI) projects are common in healthcare settings and often involve interdisciplinary teams working together towards a common goal. Many interventions and programmes have been introduced through research to convey QI skills and knowledge to healthcare workers, however, a few studies have attempted to differentiate between what individuals ‘learn’ or ‘know’ versus their capacity to apply their learnings in complex healthcare settings. Understanding and differentiating between delivery, receipt, and enactment of QI skills and knowledge is important because while enactment alone does not guarantee desired QI outcomes, it might be reasonably assumed that ‘better enactment’ is likely to lead to better outcomes. This paper describes the development, application and validation of a tool to measure enactment of core QI skills and knowledge of a complex QI intervention in a healthcare setting. Based on the Institute for Healthcare Improvement’s Model for Improvement, existing QI assessment tools, literature on enactment fidelity and our research protocols, 10 indicators related to core QI skills and knowledge were determined. Definitions and assessment criteria were tested and refined in five iterative cycles. Qualitative data from four QI teams in long-term care homes were used to test and validate the tool. The final measurement tool contains 10 QI indicators and a five-point scale. Inter-rater reliability ranged from good to excellent. Usability and acceptability among raters were considered high. This measurement tool assists in identifying strengths and weaknesses of a QI team and allows for targeted feedback on core QI components. The indicators developed in our tool and the approach to tool development may be useful in other health related contexts where similar data are collected.https://bmjopenquality.bmj.com/content/12/1/e002027.full |
| spellingShingle | Liane R Ginsburg Whitney Berta Yuting Song Matthias Hoben Adrian Wagg Carole A Estabrooks Malcolm Doupe Lauren MacEachern Jennifer A Knopp-Sihota Lisa Cranley Developing a tool to measure enactment of complex quality improvement interventions in healthcare BMJ Open Quality |
| title | Developing a tool to measure enactment of complex quality improvement interventions in healthcare |
| title_full | Developing a tool to measure enactment of complex quality improvement interventions in healthcare |
| title_fullStr | Developing a tool to measure enactment of complex quality improvement interventions in healthcare |
| title_full_unstemmed | Developing a tool to measure enactment of complex quality improvement interventions in healthcare |
| title_short | Developing a tool to measure enactment of complex quality improvement interventions in healthcare |
| title_sort | developing a tool to measure enactment of complex quality improvement interventions in healthcare |
| url | https://bmjopenquality.bmj.com/content/12/1/e002027.full |
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