Toronto General Hospital Research Institute, University Health Network, Toronto, Canada.
Health Res Policy Syst. 2021 Sep 8;19(1):123. doi: 10.1186/s12961-021-00777-z.
Quality improvement (QI) casebooks, compilations of QI experiences, are one way to share experiential knowledge that healthcare policy-makers, managers and professionals can adapt to their own contexts. However, QI casebook use, characteristics and impact are unknown. We aimed to synthesize published research on QI prevalence, development, characteristics and impact.
We conducted a scoping review by searching MEDLINE, EMBASE, CINAHL and SCOPUS from inception to 4 February 2021. We extracted data on study characteristics and casebook definitions, development, characteristics (based on the WIDER [Workgroup for Intervention Development and Evaluation Research] framework) and impact. We reported findings using summary statistics, text and tables.
We screened 2999 unique items and included five articles published in Canada from 2011 to 2020 describing three studies. Casebooks focused on promoting positive weight-related conversations with children and parents, coordinating primary care-specialist cancer management, and showcasing QI strategies for cancer management. All defined casebooks similarly described real-world experiences of developing and implementing QI strategies that others could learn from, emulate or adapt. In all studies, casebook development was a multistep, iterative, interdisciplinary process that engages stakeholders in identifying, creating and reviewing content. While casebooks differed in QI topic, level of application and scope, cases featured common elements: setting or context, QI strategy details, impacts achieved, and additional tips for implementing strategies. Cases were described with a blend of text, graphics and tools. One study evaluated casebook impact, and found that it enhanced self-efficacy and use of techniques to improve clinical care. Although details about casebook development and characteristics were sparse, we created a template of casebook characteristics, which others can use as the basis for developing or evaluating casebooks.
Future research is needed to optimize methods for developing casebooks and to evaluate their impact. One approach is to assess how the many QI casebooks available online were developed. Casebooks should be evaluated alone or in combination with other interventions that support QI on a range of outcomes.
质量改进(QI)案例集是分享经验知识的一种方式,医疗保健政策制定者、管理者和专业人员可以将这些知识应用于自己的环境中。然而,QI 案例集的使用、特点和影响尚不清楚。我们旨在综合已发表的关于 QI 流行程度、发展、特点和影响的研究。
我们通过搜索 MEDLINE、EMBASE、CINAHL 和 SCOPUS,从建库至 2021 年 2 月 4 日,进行了范围综述。我们提取了研究特征和案例集定义、发展、特点(基于 WIDER[干预开发和评估研究工作组]框架)和影响的数据。我们使用汇总统计数据、文字和表格报告研究结果。
我们筛选了 2999 个独特的项目,纳入了 2011 年至 2020 年期间在加拿大发表的五篇描述三项研究的文章。案例集侧重于促进与儿童和家长进行积极的体重相关对话、协调初级保健-专家癌症管理以及展示癌症管理的 QI 策略。所有案例集都以类似的方式定义,描述了其他人可以从中学习、模仿或改编的开发和实施 QI 策略的真实经验。在所有研究中,案例集的开发是一个多步骤、迭代、跨学科的过程,涉及利益相关者确定、创建和审查内容。虽然案例集在 QI 主题、应用程度和范围上有所不同,但案例都具有共同的要素:背景或环境、QI 策略细节、实现的影响以及实施策略的其他提示。案例是通过文本、图形和工具的混合来描述的。一项研究评估了案例集的影响,发现它增强了自我效能感和使用技术改善临床护理的能力。尽管案例集的开发和特点细节很少,但我们创建了案例集特点模板,其他人可以以此为基础来开发或评估案例集。
需要进一步研究优化案例集开发方法并评估其影响。一种方法是评估许多在线 QI 案例集是如何开发的。案例集应单独评估或与支持一系列结果的 QI 的其他干预措施结合评估。