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Journal article
Evaluating the implementation of a quality improvement process in General Practice using a realist evaluation framework
Journal of evaluation in clinical practice, v 24(4), pp 701-707
Aug 2018
PMID: 29799153
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Rationale, aims, and objectives
Underuse of anticoagulants in atrial fibrillation is known to increase the risk of stroke and is an international problem. The National Institute for Health Care and Excellence guidance CG180 seeks to reduce atrial fibrillation related strokes through prescriptions of Non‐vitamin K antagonist Oral Anticoagulants. A quality improvement programme was established by the West of England Academic Health Science Network (West of England AHSN) to implement this guidance into General Practice.
A realist evaluation identified whether the quality improvement programme worked, determining how and in what circumstances.
Methods
Six General Practices in 1 region, became the case study sites. Quality improvement team, doctor, and pharmacist meetings within each of the General Practices were recorded at 3 stages: initial planning, review, and final. Additionally, 15 interviews conducted with the practice leads explored experiences of the quality improvement process. Observation and interview data were analysed and compared against the initial programme theory.
Results
The quality improvement resources available were used variably, with the training being valued by all. The initial programme theories were refined. In particular, local workload pressures and individual General Practitioner experiences and pre‐conceived ideas were acknowledged. Where key motivators were in place, such as prior experience, the programme achieved optimal outcomes and secured a lasting quality improvement legacy.
Conclusion
The employment of a quality improvement programme can deliver practice change and improvement legacy outcomes when particular mechanisms are employed and in contexts where there is a commitment to improve service.
Metrics
Details
- Title
- Evaluating the implementation of a quality improvement process in General Practice using a realist evaluation framework
- Creators
- Pam Moule - Faculty of Health and Applied Sciences, UWE, Glenside Campus, Blackberry Hill, Stapleton, Bristol, BS16 1DD, UK.Susan Clompus - Faculty of Health and Applied Sciences, UWE, Glenside Campus, Blackberry Hill, Stapleton, Bristol, BS16 1DD, UK.Jon Fieldhouse - Faculty of Health and Applied Sciences, UWE, Glenside Campus, Blackberry Hill, Stapleton, Bristol, BS16 1DD, UK.Julie Ellis-Jones - Faculty of Health and Applied Sciences, UWE, Glenside Campus, Blackberry Hill, Stapleton, Bristol, BS16 1DD, UK.Jacqueline Barker - Faculty of Health and Applied Sciences, UWE, Glenside Campus, Blackberry Hill, Stapleton, Bristol, BS16 1DD, UK.
- Publication Details
- Journal of evaluation in clinical practice, v 24(4), pp 701-707
- Publisher
- Wiley
- Number of pages
- 7
- Grant note
- West of England AHSN (N/A)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine; Pharmacology and Physiology; Drexel University
- Web of Science ID
- WOS:000440140900004
- Scopus ID
- 2-s2.0-85047650214
- Other Identifier
- 991020099926304721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Health Care Sciences & Services
- Medical Informatics