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Background Several frameworks have been developed to identify essential determinants for healthcare improvement. These frameworks aim to be comprehensive, leading to the creation of long lists of non-prioritised determinants. Furthermore, most existing frameworks do not describe the methods or actions used to identify and address the determinants, limiting their practical value. The aim of this study is to describe the development of a tool to determine the prioritised facilitators and barriers for healthcare improvement projects led by healthcare professionals, supplemented with methods to identify and address each determinant.
Methods A mixed-methods study design was used to develop the tool. First, a cross-sectional study was performed, using an online survey to ask healthcare professionals about the determinants they experienced during the performance of their quality improvement project. A priority score was calculated for every named determinant, and those with a priority score ≥ 20 were incorporated into the tool. Semi-structured interviews with implementation experts determined: 1) how healthcare professionals can be assisted to use our tool to analyse the determinants in their project and 2) how healthcare professionals can tackle the barriers or use the facilitators identified in their quality improvement project.
Results The 25 healthcare professionals in this study experienced 64 facilitators and 66 barriers when performing their improvement projects. Of these, 12 facilitators and nine barriers were incorporated into the tool. Sufficient support from management of the department was identified as the most important facilitator, while having limited time to perform the project was considered the biggest barrier. The interviews with 16 experts in implementation science led to various inputs for better identifying and addressing each determinant. Important themes included maintaining adequate communication with stakeholders, keeping the project at a manageable size, learning by doing and being able to influence determinants.
Conclusions This paper describes a tool for performing quality improvement projects in healthcare, with the barriers and facilitators that were considered most important by healthcare professionals. For each of these barriers and facilitators, suggestions on how to analyse and address the determinant are given. More research is needed to validate and develop the tool further.
Keywords
Determinants of practice, quality improvement, healthcare professionals, tool development
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CURRENT STATUS: Published
View the published article at Implementation Science Communications.
No community comments so far
Editorial decision: Accept
On 07 Oct, 2020
Editor assigned
On 17 Sep, 2020
Submission checks complete
On 16 Sep, 2020
Editor invited
On 16 Sep, 2020
No comments provided
Editorial decision: Minor revision
On 07 Sep, 2020
Review #1 received
Received 31 Aug, 2020
Review #2 received
Received 31 Aug, 2020
Reviewer #2 agreed
On 13 Aug, 2020
Reviewers invited
Invitations sent on 10 Aug, 2020
Reviewer #1 agreed
On 10 Aug, 2020
Editor assigned
On 31 Jul, 2020
Submission checks complete
On 30 Jul, 2020
Editor invited
On 30 Jul, 2020
Version 1
Posted 20 Feb, 2020
No comments provided
Editorial decision: Major revision
On 03 Jun, 2020
Review #3 received
Received 25 May, 2020
Review #2 received
Received 25 May, 2020
Reviewer #3 agreed
On 05 May, 2020
Reviewer #2 agreed
On 04 May, 2020
Review #1 received
Received 28 Apr, 2020
Reviewers invited
Invitations sent on 08 Apr, 2020
Reviewer #1 agreed
On 08 Apr, 2020
First submitted
On 19 Feb, 2020
Editor assigned
On 19 Feb, 2020
Submission checks complete
On 18 Feb, 2020
Editor invited
On 18 Feb, 2020
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Subject Areas
Health Economics & Outcomes Research
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See the published version of this preprint at Implementation Science Communications.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Implementation Science Communications.
No community comments so far
Editorial decision: Accept
On 07 Oct, 2020
Editor assigned
On 17 Sep, 2020
Submission checks complete
On 16 Sep, 2020
Editor invited
On 16 Sep, 2020
No comments provided
Editorial decision: Minor revision
On 07 Sep, 2020
Review #1 received
Received 31 Aug, 2020
Review #2 received
Received 31 Aug, 2020
Reviewer #2 agreed
On 13 Aug, 2020
Reviewers invited
Invitations sent on 10 Aug, 2020
Reviewer #1 agreed
On 10 Aug, 2020
Editor assigned
On 31 Jul, 2020
Submission checks complete
On 30 Jul, 2020
Editor invited
On 30 Jul, 2020
Version 1
Posted 20 Feb, 2020
No comments provided
Editorial decision: Major revision
On 03 Jun, 2020
Review #3 received
Received 25 May, 2020
Review #2 received
Received 25 May, 2020
Reviewer #3 agreed
On 05 May, 2020
Reviewer #2 agreed
On 04 May, 2020
Review #1 received
Received 28 Apr, 2020
Reviewers invited
Invitations sent on 08 Apr, 2020
Reviewer #1 agreed
On 08 Apr, 2020
First submitted
On 19 Feb, 2020
Editor assigned
On 19 Feb, 2020
Submission checks complete
On 18 Feb, 2020
Editor invited
On 18 Feb, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Economics & Outcomes Research
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Implementation Science Communications.
Background Several frameworks have been developed to identify essential determinants for healthcare improvement. These frameworks aim to be comprehensive, leading to the creation of long lists of non-prioritised determinants. Furthermore, most existing frameworks do not describe the methods or actions used to identify and address the determinants, limiting their practical value. The aim of this study is to describe the development of a tool to determine the prioritised facilitators and barriers for healthcare improvement projects led by healthcare professionals, supplemented with methods to identify and address each determinant.
Methods A mixed-methods study design was used to develop the tool. First, a cross-sectional study was performed, using an online survey to ask healthcare professionals about the determinants they experienced during the performance of their quality improvement project. A priority score was calculated for every named determinant, and those with a priority score ≥ 20 were incorporated into the tool. Semi-structured interviews with implementation experts determined: 1) how healthcare professionals can be assisted to use our tool to analyse the determinants in their project and 2) how healthcare professionals can tackle the barriers or use the facilitators identified in their quality improvement project.
Results The 25 healthcare professionals in this study experienced 64 facilitators and 66 barriers when performing their improvement projects. Of these, 12 facilitators and nine barriers were incorporated into the tool. Sufficient support from management of the department was identified as the most important facilitator, while having limited time to perform the project was considered the biggest barrier. The interviews with 16 experts in implementation science led to various inputs for better identifying and addressing each determinant. Important themes included maintaining adequate communication with stakeholders, keeping the project at a manageable size, learning by doing and being able to influence determinants.
Conclusions This paper describes a tool for performing quality improvement projects in healthcare, with the barriers and facilitators that were considered most important by healthcare professionals. For each of these barriers and facilitators, suggestions on how to analyse and address the determinant are given. More research is needed to validate and develop the tool further.
This is a list of supplementary files associated with this preprint. Click to download.
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