Toward an Evidence-Based System for Innovation Support for Implementing Innovations with Quality: Tools, Training, Technical Assistance, and Quality Assurance/Quality Improvement

We revised briefly: The origins of audit in the health sector and the historical variation of this concept. This concept has switched from a sanctional tool to a methodology of quality assurance and continuous quality improvement. International trends and the so called Evidence-based audit are also analized.

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Evidence-based Quality Improvement in University Language Didactics

Language Learning in Higher Education ◽

10.1515/cercles-2018-0010 ◽

2018 ◽

Vol 8 (1) ◽

pp. 173-185

Author(s):

Daniela Unger-Ullmann

Keyword(s):

Quality Assurance ◽

Quality Improvement ◽

Language Teaching ◽

Supply And Demand ◽

Evidence Based ◽

Research Strategies ◽

Teaching And Research ◽

Research Findings ◽

The University ◽

Young Researchers

Abstract This report describes the opportunities, challenges and limits of evidence-based quality improvement in university language teaching. Using treffpunkt sprachen – Centre for Language, Plurilingualism and Didactics at the University of Graz as an example, it provides a brief explanation of the centre and then presents the prioritization of content in teaching and research. In the process, it is necessary to investigate the supply and demand for courses and to use statistics as evidence. In addition, research strategies to promote young researchers are presented whose realization documents the development of the language centre into a centre of research on university didactics. Next, an analysis is made of effective quality assurance measures that are able to be determined in the purposeful application of research findings. Finally, opportunities and potentials in teaching and research are scrutinized and their positive implications for the centre are explained.

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A quality improvement program within the research setting to improve cancer clinical trial recruitment, accrual, and retention.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.34_suppl.124 ◽

2012 ◽

Vol 30 (34_suppl) ◽

pp. 124-124

Author(s):

Margo Michaels ◽

Judith Blanchard ◽

Kathleen Reims ◽

Kevin Little ◽

Gina Pokrashevsky

Keyword(s):

Clinical Trials ◽

Quality Improvement ◽

Best Practices ◽

Technical Assistance ◽

Minority Groups ◽

Lessons Learned ◽

Trial Participation ◽

Evidence Based ◽

Improvement Program ◽

Menu Selection

124 Background: Participation in and access to cancer treatment clinical trials (CCTs) is a key measure for delivery of quality cancer care. Yet adult trial participation in the U.S. remains under 3%, with even lower participation rates among minority groups and people over 65. There is little evidence for best practices in CCT accrual. If institutions are to be evaluated by the access they provide to CCTs, it is critical to identify practical, evidence-based approaches to maximize the efficiency of CCT recruitment, accrual, and retention efforts. The National Cancer Clinical Trials Pilot Breakthrough Collaborative (NCCTBC) is the first-ever national effort to identify such best practices in a real world setting. Methods: The purpose of this pilot was to test the feasibility of applying a proven quality improvement process to CCT accrual. More than 150 evidence-based changes to processes and procedures were identified. Five community oncology practices designed, tested, and implemented changes and reported monthly on 6 core measures to gauge improvement. Teams collaborated to share challenges and were provided coaching and technical assistance by national experts. Results: Teams have tested 35 changes over a 10-month period. Outcomes from the pilot are already showing promising results in identifying those changes that can have the most impact on improving accrual. For example: Improvements in race and ethnicity data capture are helping to address disparities in patient census. Improvements in processes for trial menu selection are leading to new ways of assessing patient populations and finding trials that match them. Documentation of pre-screening and offer rates is identifying system gaps and ways to increase these rates. Conclusions: Results affirm the feasibility of applying a quality improvement framework to address persistently low accrual rates and decrease health disparities among racial and ethnic minorities and the elderly. Based on lessons learned, we are making improvements to the NCCTBC infrastructure and processes and plan to recruit 10 new teams to test further changes.

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Quality Assurance and Quality Improvement With the FFT Drug Abuse Contingency Management Module

PsycEXTRA Dataset ◽

10.1037/e637702012-001 ◽

2012 ◽

Author(s):

Michael Robbins

Keyword(s):

Quality Assurance ◽

Quality Improvement ◽

Drug Abuse ◽

Contingency Management

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Virtual external implementation facilitation: successful methods for remotely engaging groups in quality improvement

Implementation Science Communications ◽

10.1186/s43058-021-00168-z ◽

2021 ◽

Vol 2 (1) ◽

Author(s):

Christine W. Hartmann ◽

Ryann L. Engle ◽

Camilla B. Pimentel ◽

Whitney L. Mills ◽

Valerie A. Clark ◽

...

Keyword(s):

Public Health ◽

Quality Improvement ◽

Evidence Based ◽

National Program ◽

Extensive Experience ◽

Evidence Based Practices ◽

Team Members ◽

Virtual Experience ◽

Key Points ◽

Program Content

Abstract Background Relatively little guidance exists on how to use virtual implementation facilitation to successfully implement evidence-based practices and innovations into clinical programs. Yet virtual methods are increasingly common. They have potentially wider reach, emergent public health situations necessitate their use, and restrictions on resources can make them more attractive. We therefore outline a set of principles for virtual external implementation facilitation and a series of recommendations based on extensive experience successfully using virtual external implementation facilitation in a national program. Model and recommendations Success in virtual external implementation facilitation may be achieved by facilitators applying three overarching principles: pilot everything, incorporate a model, and prioritize metacognition. Five practical principles also help: plan in advance, communicate in real time, build relationships, engage participants, and construct a virtual room for participants. We present eight concrete suggestions for enacting the practical principles: (1) assign key facilitation roles to facilitation team members to ensure the program runs smoothly; (2) create small cohorts of participants so they can have meaningful interactions; (3) provide clarity and structure for all participant interactions; (4) structure program content to ensure key points are described, reinforced, and practiced; (5) use visuals to supplement audio content; (6) build activities into the agenda that enable participants to immediately apply knowledge at their own sites, separate from the virtual experience; (7) create backup plans whenever possible; and (8) engage all participants in the program. Summary These principles represent a novel conceptualization of virtual external implementation facilitation, giving structure to a process that has been, to date, inadequately described. The associated actions are demonstrably useful in supporting the principles and offer teams interested in virtual external implementation facilitation concrete methods by which to ensure success. Our examples stem from experiences in healthcare. But the principles can, in theory, be applied to virtual external implementation facilitation regardless of setting, as they and the associated actions are not setting specific.

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Effect of collaborative quality improvement on stillbirths, neonatal mortality and newborn care practices in hospitals of Telangana and Andhra Pradesh, India: evidence from a quasi-experimental mixed-methods study

Implementation Science ◽

10.1186/s13012-020-01058-z ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Karen Zamboni ◽

Samiksha Singh ◽

Mukta Tyagi ◽

Zelee Hill ◽

Claudia Hanson ◽

...

Keyword(s):

Quality Improvement ◽

Neonatal Mortality ◽

Process Evaluation ◽

Andhra Pradesh ◽

Newborn Care ◽

Mechanisms Of Change ◽

Evidence Based ◽

Programme Implementation ◽

Quasi Experimental ◽

Care Practices

Abstract Background Improving quality of care is a key priority to reduce neonatal mortality and stillbirths. The Safe Care, Saving Lives programme aimed to improve care in newborn care units and labour wards of 60 public and private hospitals in Telangana and Andhra Pradesh, India, using a collaborative quality improvement approach. Our external evaluation of this programme aimed to evaluate programme effects on implementation of maternal and newborn care practices, and impact on stillbirths, 7- and 28-day neonatal mortality rate in labour wards and neonatal care units. We also aimed to evaluate programme implementation and mechanisms of change. Methods We used a quasi-experimental plausibility design with a nested process evaluation. We evaluated effects on stillbirths, mortality and secondary outcomes relating to adherence to 20 evidence-based intrapartum and newborn care practices, comparing survey data from 29 hospitals receiving the intervention to 31 hospitals expected to receive the intervention later, using a difference-in-difference analysis. We analysed programme implementation data and conducted 42 semi-structured interviews in four case studies to describe implementation and address four theory-driven questions to explain the quantitative results. Results Only 7 of the 29 intervention hospitals were engaged in the intervention for its entire duration. There was no evidence of an effect of the intervention on stillbirths [DiD − 1.3 percentage points, 95% CI − 2.6–0.1], on neonatal mortality at age 7 days [DiD − 1.6, 95% CI − 9–6.2] or 28 days [DiD − 3.0, 95% CI − 12.9—6.9] or on adherence to target evidence-based intrapartum and newborn care practices. The process evaluation identified challenges in engaging leaders; challenges in developing capacity for quality improvement; and challenges in activating mechanisms of change at the unit level, rather than for a few individuals, and in sustaining these through the creation of new social norms. Conclusion Despite careful planning and substantial resources, the intervention was not feasible for implementation on a large scale. Greater focus is required on strategies to engage leadership. Quality improvement may need to be accompanied by clinical training. Further research is also needed on quality improvement using a health systems perspective.

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Evaluating context-specific evidence-based quality improvement intervention on lymphatic filariasis mass drug administration in Northern Ghana using the RE-AIM framework

Tropical Medicine and Health ◽

10.1186/s41182-021-00305-3 ◽

2021 ◽

Vol 49 (1) ◽

Author(s):

Alfred Kwesi Manyeh ◽

Tobias Chirwa ◽

Rohit Ramaswamy ◽

Frank Baiden ◽

Latifat Ibisomi

Keyword(s):

Quality Improvement ◽

Needs Assessment ◽

Lymphatic Filariasis ◽

Drug Administration ◽

Mass Drug Administration ◽

Northern Ghana ◽

Quality Improvement Intervention ◽

Evidence Based ◽

Context Specific ◽

Improvement Intervention

Abstract Background Over a decade of implementing a global strategy to eliminate lymphatic filariasis in Ghana through mass drug administration, the disease is still being transmitted in 11 districts out of an initial 98 endemic districts identified in 2000. A context-specific evidence-based quality improvement intervention was implemented in the Bole District of Northern Ghana after an initial needs assessment to improve the lymphatic filariasis mass drug administration towards eliminating the disease. Therefore, this study aimed to evaluate the process and impact of the lymphatic filariasis context-specific evidence-based quality improvement intervention in the Bole District of Northern Ghana. Method A cross-sectional mixed methods study using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate the context-specific evidence-based quality improvement intervention was employed. Quantitative secondary data was extracted from the neglected tropical diseases database. A community survey was conducted with 446 randomly selected participants. Qualitative data were collected from 42 purposively selected health workers, chiefs/opinion leaders and community drug distributors in the study area. Results The evaluation findings showed an improvement in social mobilisation and sensitisation, knowledge about lymphatic filariasis and mass drug administration process, willingness to ingest the medication and adherence to the direct observation treatment strategy. We observed an increase in coverage ranging from 0.1 to 12.3% after implementing the intervention at the sub-district level and reducing self-reported adverse drug reaction. The level of reach, effectiveness and adoption at the district, sub-district and individual participants’ level suggest that the context-specific evidence-based quality improvement intervention is feasible to implement in lymphatic filariasis hotspot districts based on initial context-specific needs assessment. Conclusion The study provided the groundwork for future application of the RE-AIM framework to evaluate the implementation of context-specific evidence-based quality improvement intervention to improve lymphatic filariasis mass drug administration towards eliminating the disease as a public health problem.

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