Are quality improvement collaboratives effective? A systematic review.

Show simple item record Wells, Linda en Tamir, Orly en Gray, Jonathon en Naidoo, Dhevaksha en Bekhit, Mark en Goldmann, Don en 2018-11-20T00:25:34Z en 2018-03 en
dc.identifier.issn 2044-5415 en
dc.identifier.uri en
dc.description.abstract BACKGROUND:Quality improvement collaboratives (QIC) have proliferated internationally, but there is little empirical evidence for their effectiveness. METHOD:We searched Medline, Embase, CINAHL, PsycINFO and the Cochrane Library databases from January 1995 to December 2014. Studies were included if they met the criteria for a QIC intervention and the Cochrane Effective Practice and Organisation of Care (EPOC) minimum study design characteristics for inclusion in a review. We assessed study bias using the EPOC checklist and the quality of the reported intervention using a subset of SQUIRE 1.0 standards. RESULTS:Of the 220 studies meeting QIC criteria, 64 met EPOC study design standards for inclusion. There were 10 cluster randomised controlled trials, 24 controlled before-after studies and 30 interrupted time series studies. QICs encompassed a broad range of clinical settings, topics and populations ranging from neonates to the elderly. Few reports fully described QIC implementation and methods, intensity of activities, degree of site engagement and important contextual factors. By care setting, an improvement was reported for one or more of the study's primary effect measures in 83% of the studies (32/39 (82%) hospital based, 17/20 (85%) ambulatory care, 3/4 nursing home and a sole ambulance QIC). Eight studies described persistence of the intervention effect 6 months to 2 years after the end of the collaborative. Collaboratives reporting success generally addressed relatively straightforward aspects of care, had a strong evidence base and noted a clear evidence-practice gap in an accepted clinical pathway or guideline. CONCLUSIONS:QICs have been adopted widely as an approach to shared learning and improvement in healthcare. Overall, the QICs included in this review reported significant improvements in targeted clinical processes and patient outcomes. These reports are encouraging, but most be interpreted cautiously since fewer than a third met established quality and reporting criteria, and publication bias is likely. en
dc.format.medium Print-Electronic en
dc.language eng en
dc.relation.ispartofseries BMJ quality & safety en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri en
dc.subject Humans en
dc.subject Cooperative Behavior en
dc.subject Learning en
dc.subject Organizational Innovation en
dc.subject Delivery of Health Care en
dc.subject Outcome and Process Assessment (Health Care) en
dc.subject Evidence-Based Practice en
dc.subject Quality Improvement en
dc.title Are quality improvement collaboratives effective? A systematic review. en
dc.type Journal Article en
dc.identifier.doi 10.1136/bmjqs-2017-006926 en
pubs.issue 3 en
pubs.begin-page 226 en
pubs.volume 27 en
dc.rights.holder Copyright: The author en
dc.identifier.pmid 29055899 en
pubs.end-page 240 en
pubs.publication-status Published en
dc.rights.accessrights en
pubs.subtype Systematic Review en
pubs.subtype Journal Article en
pubs.elements-id 705798 en Medical and Health Sciences en Population Health en Epidemiology & Biostatistics en
dc.identifier.eissn 2044-5423 en
pubs.record-created-at-source-date 2017-10-23 en
pubs.dimensions-id 29055899 en

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