Identifying contextually relevant improvement measures, illustrated by a case of executive walkrounds.

IF 1 Q4 HEALTH POLICY & SERVICES

INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE Pub Date : 2020-04-21 DOI:10.1108/IJHCQA-08-2019-0140

Nick J Reed, Natalie Wilson, Kathryn J Hayes

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Abstract

Purpose: A method to engage salient organisational stakeholders in identifying and ranking measures of healthcare improvement programs is described. The method is illustrated using Executive WalkRounds (EWRs) in a multi-site Australian Health District.

Design/methodology/approach: Subject matter experts (SMEs) conducted document analysis, identified potential EWRs measures, created driver diagrams and then eliminated weak measures. Next, a panel of executives skilled in EWRs ranked and ratified the potential measures using a modified Delphi technique.

Findings: EWRs measurement selection demonstrated the feasibility of the method. Of the total time to complete the method 79% was contributed by SMEs, 14% by administration personnel and 7% by executives. Document analysis revealed three main EWRs aims. Ten of 28 potential measures were eliminated by the SME review. After repeated Delphi rounds the executive panel achieved consensus (75% cut-off) on seven measures. One outcome, one process and one implementation fidelity metric were selected to measure and monitor the impact of EWRs in the health district.

Practical implications: Perceptions of weak relationships between measures and intended improvements can lead to practitioner scepticism. This work offers a structured method to combine the technical expertise of SMEs with the practical knowledge of healthcare staff in selecting improvement measures.

Originality/value: This research describes and demonstrates a novel method to systematically leverage formal and practical types of expertise to select measures that are strongly linked to local quality improvement goals. The method can be applied in diverse healthcare settings.

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识别上下文相关的改进措施，通过执行巡查的案例来说明。

目的:描述了一种方法，以参与显著的组织利益相关者识别和排名措施的医疗保健改善方案。该方法是用行政巡诊(EWRs)在多站点澳大利亚卫生区说明。设计/方法论/方法:主题专家(sme)进行文档分析，确定潜在的EWRs度量，创建驱动图，然后消除弱度量。接下来，一组在EWRs方面熟练的高管使用改进的德尔菲技术对可能的措施进行排名和批准。结果:EWRs测量选择证明了该方法的可行性。在完成该方法的总时间中，中小企业贡献了79%，管理人员贡献了14%，高管贡献了7%。文献分析揭示了EWRs的三个主要目标。28项潜在措施中的10项在中小企业审查中被淘汰。经过反复的德尔菲轮次，执行小组在七项措施上达成了共识(75%的截止)。选择了一个结果、一个过程和一个实施保真度指标来衡量和监测卫生区EWRs的影响。实际含义:对措施和预期改进之间的弱关系的认识可能导致从业者怀疑。这项工作提供了一种结构化的方法，将中小企业的技术专长与医护人员的实践知识结合起来，选择改进措施。原创性/价值:本研究描述并展示了一种新颖的方法，系统地利用正式和实用类型的专业知识来选择与当地质量改进目标密切相关的措施。该方法可应用于不同的医疗保健环境。

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来源期刊

INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE HEALTH POLICY & SERVICES-

CiteScore

4.00

自引率

6.70%

发文量

期刊介绍： ■Successful quality/continuous improvement projects ■The use of quality tools and models in leadership management development such as the EFQM Excellence Model, Balanced Scorecard, Quality Standards, Managed Care ■Issues relating to process control such as Six Sigma, Leadership, Managing Change and Process Mapping ■Improving patient care through quality related programmes and/or research Articles that use quantitative and qualitative methods are encouraged.