Significant changes in specific QI domains are possible to detect during a 3-year period. Our research gives us confidence that the QI Maturity Tool measures the right domains and is an important contribution to quantifying the adoption and spread of QI in public health. However, further refinement is needed to better standardize language and definitions of the component parts of a QI system.
The third phase of the Multi-State Learning Collaborative (MLC) is a 3-year Robert Wood Johnson Foundation initiative designed to build quality improvement capacity within state and local health departments. This commentary provides a brief overview of the MLC, a methodological description of its evaluation, and preliminary findings. Major evaluation data sources include quarterly reports, surveys, case studies, and key informant interviews. Preliminary survey data and quarterly reports from year 1 provide some early evidence that states are progressing toward MLC goals. Approximately 27 percent of local health departments in the 16 participant states report that they have begun to prepare for national accreditation and approximately 39 percent report implementation of at least one quality improvement project within the past 12 months. Ongoing data collection efforts are underway to more fully address the evaluation questions.
Changes in the patient record from the paper to the electronic health record format present challenges and opportunities for the nurse researcher. Current use of data from the electronic health record is in a state of flux. Novel data analytic techniques and massive data sets provide new opportunities for nursing science. Realization of a strong electronic data output future relies on meeting challenges of system use and operability, data presentation, and privacy. Nurse researchers need to rethink aspects of proposal development. Joining ongoing national efforts aimed at creating usable data output is encouraged as a means to affect system design. Working to address challenges and embrace opportunities will help grow the science in a way that answers important patient care questions.
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