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首页> 外文期刊>The joint commission journal on quality and patient safety >Designing Quality Improvement Collaboratives for Dissemination: Lessons from a Multiple Case Study of the Implementation of Obstetric Emergency Safety Bundles
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Designing Quality Improvement Collaboratives for Dissemination: Lessons from a Multiple Case Study of the Implementation of Obstetric Emergency Safety Bundles

机译：设计质量改进协作以进行传播：从多种案例研究实施产科应急安全捆绑的课程

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摘要

Background: Quality improvement collaboratives (QICs) can help to disseminate evidence-based practices, but there is limited guidance from the perspectives of QIC organizers and participants of best practices to support practice change. To address this gap, this study aimed to identify key structures and processes of QICs that support dissemination and implementation of quality improvement projects. Methods: Semistructured one-on-one and group interviews were conducted from December 2017 to May 2018 with project administrators ( n = 28) at three QICs that had been funded to develop and disseminate obstetric emergency safety bundles in more than 300 hospitals across five states. For further study, the project leads ( n = 25) at six hospitals nominated by each QIC were interviewed. A multiple case study design was used to evaluate the dissemination strategies of each of the three QICs. For the QIC interviews, questions asked about dissemination approach, and for the hospital interviews, questions asked about implementation facilitators and barriers. All interviews were transcribed, coded, and analyzed using both deductive and inductive methods. Results: A key element supporting the dissemination strategy of each QIC was leveraging existing partnerships and rela- tionships and promoting a shared vision with participating hospitals. A robust data infrastructure to support the project was identified as a critical element to support dissemination, yet was a challenge for the QICs. Conclusion: These findings highlight specific elements of a dissemination approach that QICs can deploy to support their dissemination efforts. In particular, building data infrastructure may be a useful strategy to support ongoing quality improvement projects.
机译：背景：质量改进协作（QICS）可以帮助传播基于证据的实践，但QIC组织者和最佳实践的参与者的观点导致了有限的指导，以支持实践变革。为了解决这一差距，本研究旨在确定支持传播和实施质量改进项目的QICS的关键结构和过程。方法：半核查一对一和集团访谈是从2017年12月到2018年5月，项目管理员（N = 28）在三种QICS中，已被资助开发和传播超过五个州的300多名医院的产科应急安全捆绑包。对于进一步的研究，采访了每个QIC提名的六家医院的项目领导（n = 25）。多种案例研究设计用于评估三种QIC中的每一个的传播策略。对于QIC访谈，问题询问了传播方法，以及医院访谈，问题询问了实施协调人和障碍。所有访谈都使用演绎和归纳方法转录，编码和分析和分析。结果：支持每个QIC的传播策略的关键要素正在利用现有的伙伴关系和关系，并促进与参与医院的共同愿景。支持该项目的强大数据基础架构被确定为支持传播的关键元素，但验证了验证。结论：这些发现突出了QICS可以部署以支持其传播努力的传播方法的具体元素。特别是，建立数据基础架构可能是支持持续质量改进项目的有用策略。

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    Daniel M. Walker; Matthew J. DePuccio; Timothy R. Huerta; Ann Scheck McAlearney;

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    Department of Family Medicine The Ohio State University (OSU) College of Medicine and Core Faculty Center for Advacement of Team Science Analytics and Systems Thinking in Health Services and Implementation Science Research (CATALYST) OSU;

    CATALYST;

    Departments of Family Medicine and Biomedical Informatics OSU College of Medicine and Associate Director CATALYST;

    Department of Family Medicine OSU College of Medicine and Executive Director CATALYST;

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