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Development of a tool for identifying and addressing prioritised determinants of quality improvement projects led by healthcare professionals: a mixed-methods study
Anne van Tuijl
Radboudumc
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5515-3966
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version 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 determinants that are not prioritised based on being experienced as most important. 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 with prioritised facilitators and barriers supplemented with methods to identify and address each determinant. The tool can be used by those performing quality improvement initiatives in healthcare practice.
Methods: A mixed-methods study design was used to develop the tool. First, an online survey was used to ask healthcare professionals about determinants they experienced as most facilitating and most hindering during the performance of their quality improvement initiative. 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 were performed to gain insight on how to analyse and address the determinants in our tool.
Results: The 25 healthcare professionals in this study experienced 64 facilitators and 66 barriers when performing their improvement initiatives. 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 initiative was considered the most important barrier. The interviews with 16 experts in implementation science led to various inputs for identifying and addressing each determinant. Important themes included maintaining adequate communication with stakeholders, keeping the initiative at a manageable size, learning by doing and being able to influence determinants. Conclusions: This paper describes the development of a tool with prioritized determinants for performing quality improvement initiatives with suggestions for analysing and addressing these determinants. The tool is developed for those engaged in quality improvement initiatives in practice, so in this ways it helps to bridging the research to practice gap of determinants frameworks. 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
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Posted 18 Sep, 2020
Published
On 23 Oct, 2020
No community comments so far
Editorial decision: Accept
On 07 Oct, 2020
Editor assigned
On 17 Sep, 2020
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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
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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This preprint is under consideration at Implementation Science Communications. A preprint is 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
Development of a tool for identifying and addressing prioritised determinants of quality improvement projects led by healthcare professionals: a mixed-methods study
Anne van Tuijl
Radboudumc
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5515-3966
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
Version 3
Posted 18 Sep, 2020
Published
On 23 Oct, 2020
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
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 version 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 determinants that are not prioritised based on being experienced as most important. 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 with prioritised facilitators and barriers supplemented with methods to identify and address each determinant. The tool can be used by those performing quality improvement initiatives in healthcare practice.
Methods: A mixed-methods study design was used to develop the tool. First, an online survey was used to ask healthcare professionals about determinants they experienced as most facilitating and most hindering during the performance of their quality improvement initiative. 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 were performed to gain insight on how to analyse and address the determinants in our tool.
Results: The 25 healthcare professionals in this study experienced 64 facilitators and 66 barriers when performing their improvement initiatives. 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 initiative was considered the most important barrier. The interviews with 16 experts in implementation science led to various inputs for identifying and addressing each determinant. Important themes included maintaining adequate communication with stakeholders, keeping the initiative at a manageable size, learning by doing and being able to influence determinants. Conclusions: This paper describes the development of a tool with prioritized determinants for performing quality improvement initiatives with suggestions for analysing and addressing these determinants. The tool is developed for those engaged in quality improvement initiatives in practice, so in this ways it helps to bridging the research to practice gap of determinants frameworks. More research is needed to validate and develop the tool further.
Figure 1
Figure 2