Abstract:
OBJECTIVE:To explore whether differences between collaboratives with respect to type of topic, type of targets, measures (systems) are also reflected in the degree of effectiveness. STUDY SETTING:182 teams from long-term healthcare organisation developed improvement initiatives in seven quality-improvement collaboratives (QICs) focusing on patient safety and autonomy. STUDY DESIGN:Multiple case before-after study. DATA COLLECTION:75 team leaders completed a written questionnaire at the end of each QIC on achievability and degree of challenge of targets and measurability of progress. Main outcome indicators were collaborative-specific measures (such as prevalence of pressure ulcers). PRINCIPAL FINDINGS:The degree of effectiveness and percentage of teams realising targets varied between collaboratives. Collaboratives also varied widely in perceived measurability (F=6.798 and p=0.000) and with respect to formulating achievable targets (F=6.566 and p=0.000). The Problem Behaviour collaborative scored significantly lower than all other collaboratives on both dimensions. The collaborative on Autonomy and control scored significantly lower on measurability than the other collaboratives. Topics for which there are best practices and evidence of effective interventions do not necessarily score higher on effectiveness, measurability, achievable and challenging targets. CONCLUSIONS:The effectiveness of a QIC is associated with the efforts of programme managers to create conditions that provide insight into which changes in processes of care and in client outcomes have been made. Measurability is not an inherent property of the improvement topic. Rather, creating measurability and formulating challenging and achievable targets is one of the crucial tasks for programme managers of QICs.
journal_name
BMJ Qual Safjournal_title
BMJ quality & safetyauthors
Strating MM,Nieboer AP,Zuiderent-Jerak T,Bal RAdoi
10.1136/bmjqs.2010.047159subject
Has Abstractpub_date
2011-04-01 00:00:00pages
344-50issue
4eissn
2044-5415issn
2044-5423pii
bmjqs.2010.047159journal_volume
20pub_type
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