Fishman Ariel Y, Lounsbury David W, Lechuga Claudia, Patena John, Marantz Paul, Kim Mimi, Keller Marla J
Harold and Muriel Block Institute for Clinical and Translational Research, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
J Clin Transl Sci. 2024 May 30;8(1):e103. doi: 10.1017/cts.2024.555. eCollection 2024.
Structured processes to improve the quality and impact of clinical and translational research are a required element of the Clinical and Translational Sciences Awards (CTSA) program and are central to awardees' strategic management efforts. Quality improvement is often assumed to be an ordinary consequence of evaluation programs, in which standardized metrics are tabulated and reported externally. Yet evaluation programs may not actually be very effective at driving quality improvement: required metrics may lack direct relevance; they lack incentive to improve on areas of relative strength; and the validity of inter-site comparability may be limited. In this article, we describe how we convened leaders at our CTSA hub in an iterative planning process to improve the quality of our CTSA program by intentionally focusing on how data collection activities can primarily advance continuous quality improvement (CQI) rather than strictly serve as evaluative tools. We describe our CQI process, which consists of three key components: (1) Logic models outlining goals and associated mechanisms; (2) relevant metrics to evaluate performance improvement opportunities; and (3) an interconnected and collaborative CQI framework that defines actions and timelines to enhance performance.
旨在提高临床与转化研究质量及影响力的结构化流程是临床与转化科学奖(CTSA)项目的必要组成部分,也是获奖者战略管理工作的核心。质量改进通常被认为是评估项目的自然结果,在评估项目中,标准化指标会被整理并对外报告。然而,评估项目在推动质量改进方面可能实际上并不十分有效:所需指标可能缺乏直接相关性;它们缺乏在相对优势领域进行改进的激励;而且站点间可比性的有效性可能有限。在本文中,我们描述了我们如何在CTSA中心召集领导者参与一个迭代规划过程,通过有意关注数据收集活动如何主要推动持续质量改进(CQI)而非仅仅作为评估工具,来提高我们CTSA项目的质量。我们描述了我们的CQI流程,它由三个关键部分组成:(1)概述目标及相关机制的逻辑模型;(2)用于评估绩效改进机会的相关指标;(3)一个相互关联且协作的CQI框架,该框架定义了提高绩效的行动和时间表。