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评估质量改进合作:一种混合方法。

Evaluating a quality improvement collaborative: a hybrid approach.

机构信息

School of Health and Social Care, Swansea University, Swansea, UK.

Hywel Dda University Health Board, Carmarthen, UK.

出版信息

J Health Organ Manag. 2022 Oct 3;ahead-of-print(ahead-of-print). doi: 10.1108/JHOM-11-2021-0397.

Abstract

PURPOSE

Quality improvement collaboratives (QICs) are a popular approach to improving healthcare services and patient outcomes. This paper evaluates a QIC implemented by a large, integrated healthcare organisation in Wales in the UK.

DESIGN/METHODOLOGY/APPROACH: This evaluation study draws on two well-established evaluation frameworks: Kirkpatrick's approach to gather data on participant satisfaction and learning and Stake's approach to gather data and form judgements about the impact of the intervention. A mixed methods approach was taken which included documentary analysis, surveys, semi-structured interviews, and observation of the QIC programme.

FINDINGS

Together the two frameworks provide a rounded interpretation of the extent to which the QIC intervention was fit-for-purpose. Broadly the evaluation of the QIC was positive with some areas of improvement identified.

RESEARCH LIMITATIONS/IMPLICATIONS: This study is limited to a QIC conducted within one organisation. Further testing of the hybrid framework is needed that extends to different designs of QICs.

PRACTICAL IMPLICATIONS

A hybrid framework is provided to assist those charged with designing and evaluating QICs.

ORIGINALITY/VALUE: Evaluation studies are limited on QICs and if present tend to adopt one framework. Given the complexities of undertaking quality improvement within healthcare, this study uniquely takes a hybrid approach.

摘要

目的

质量改进合作(QIC)是一种改进医疗服务和患者结果的流行方法。本文评估了英国威尔士的一家大型综合医疗保健组织实施的 QIC。

设计/方法/方法:这项评估研究借鉴了两个成熟的评估框架:Kirkpatrick 的方法收集参与者满意度和学习的数据,以及 Stake 的方法收集干预措施影响的数据和形成判断。采用混合方法,包括文献分析、调查、半结构化访谈和 QIC 计划的观察。

结果

这两个框架共同提供了一个全面的解释,说明 QIC 干预措施在多大程度上适合目的。总体而言,对 QIC 的评估是积极的,确定了一些需要改进的领域。

研究局限性/影响:本研究仅限于一个组织内进行的 QIC。需要进一步测试扩展到不同 QIC 设计的混合框架。

实际影响

提供了一个混合框架,以帮助那些负责设计和评估 QIC 的人。

原创性/价值:关于 QIC 的评估研究有限,如果存在,往往采用一种框架。考虑到在医疗保健领域进行质量改进的复杂性,这项研究独特地采用了混合方法。

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