Perspectives on Implementing Quality Improvement Collaboratives Effectively: Qualitative Findings from the CHIPRA Quality Demonstration Grant Program

Burton, Rachel A.; Peters, Rebecca Anne; Devers, Kelly J.

doi:10.1016/j.jcjq.2017.08.004

Cited by 6 publications

(10 citation statements)

References 18 publications

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“…A prior systematic review of 12 QI collaboratives found that participants value peer-to-peer learning opportunities. 8 SPARC also provided a framework for accountability through intervention implementation plans and monthly follow-up calls. As hospitals progressed and priorities shifted, continuous reporting was perceived as burdensome.…”

Section: Discussionmentioning

confidence: 99%

“…We constructed mixed-effects negative binomial models regressing quarterly C. difficile counts on a dichotomous variable indicating intervention versus control group; dummy variables for time periods; interactions of the intervention group and time period dummy variables, and hospital-level random intercepts to account for the clustering of repeated measures from the same hospital, with an offset of patient-days. The regression model included the predicted C. difficile counts as a covariate, a measure generated by NHSN using negative binomial regression models that adjust for C. difficile test type, hospital type, hospital bed number, intensive care unit bed number, teaching status and C. difficile community-onset cases across hospitals 8 24. Incidence rate ratios (IRR) and 95% CIs are reported, and p<0.05 defined as statistical significance.…”

Section: Methodsmentioning

confidence: 99%

“…4 Together, they created the Statewide Prevention Quality improvement report and Reduction of C. difficile (SPARC) collaborative as a novel state public health-academic partnership to enhance hospital-based quality improvement (QI) efforts towards C. difficile reduction. [5][6][7][8][9][10] The objectives of this QI report are to: describe SPARC; conduct a pre-post quantitative assessment of changes in C. difficile incidence rates for SPARC intervention versus control hospitals (outcome measure); and qualitatively assess hospital perspectives of the collaborative (process measures). This paper follows the Standards for Quality Improvement Reporting Excellence reporting guidelines for QI interventions.…”

Section: Introductionmentioning

confidence: 99%

“…The Maryland Department of Health leveraged Centers for Disease Control and Prevention (CDC) Epidemiology and Laboratory Capacity funding (5 NU50CK000506-02-00), developing a partnership with two academic institutions: the University of Maryland, Baltimore, and Johns Hopkins University, both designated CDC Prevention Epicenters for infection prevention research 4. Together, they created the Statewide Prevention and Reduction of C. difficile (SPARC) collaborative as a novel state public health–academic partnership to enhance hospital-based quality improvement (QI) efforts towards C. difficile reduction 5–10…”

Section: Introductionmentioning

confidence: 99%

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Impact of Statewide Prevention and Reduction of Clostridioides difficile (SPARC), a Maryland public health–academic collaborative: an evaluation of a quality improvement intervention

et al. 2021

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To evaluate changes in Clostridioides difficile incidence rates for Maryland hospitals that participated in the Statewide Prevention and Reduction of C. difficile (SPARC) collaborative. Pre-post, difference-in-difference analysis of non-randomised intervention using four quarters of preintervention and six quarters of postintervention National Healthcare Safety Network data for SPARC hospitals (April 2017 to March 2020) and 10 quarters for control hospitals (October 2017 to March 2020). Mixed-effects negative binomial models were used to assess changes over time. Process evaluation using hospital intervention implementation plans, assessments and interviews with staff at eight SPARC hospitals. Maryland, USA. All Maryland acute care hospitals; 12 intervention and 36 control hospitals. Participation in SPARC, a public health–academic collaborative made available to Maryland hospitals, with staggered enrolment between June 2018 and August 2019. Hospitals with higher C. difficile rates were recruited via email and phone. SPARC included assessments, feedback reports and ongoing technical assistance. Primary outcomes were C. difficile incidence rate measured as the quarterly number of C. difficile infections per 10 000 patient-days (outcome measure) and SPARC intervention hospitals’ experiences participating in the collaborative (process measures). SPARC invited 13 hospitals to participate in the intervention, with 92% (n=12) participating. The 36 hospitals that did not participate served as control hospitals. SPARC hospitals were associated with 45% greater C. difficile reduction as compared with control hospitals (incidence rate ratio=0.55, 95% CI 0.35 to 0.88, p=0.012). Key SPARC activities, including access to trusted external experts, technical assistance, multidisciplinary collaboration, an accountability structure, peer-to-peer learning opportunities and educational resources, were associated with hospitals reporting positive experiences with SPARC. SPARC intervention hospitals experienced 45% greater reduction in C. difficile rates than control hospitals. A public health–academic collaborative might help reduce C. difficile and other hospital-acquired infections in individual hospitals and at state or regional levels.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of Statewide Prevention and Reduction of Clostridioides difficile (SPARC), a Maryland public health–academic collaborative: an evaluation of a quality improvement intervention

et al. 2021

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“…1,2 The literature reveals that learning collaboratives include numerous common components: topic selection, expert faculty, participating organizations and multidisciplinary interprofessional teams, institutional leadership support, advance work, measurement, model for improvement, in-person learning sessions, individual team action periods for implementation and experimentation, and flexibility to adapt at the site level. 3-11…”

mentioning

confidence: 99%

Learning Collaboratives in Medical Education: Exploring the Impact of Collaboratives’ Structure and Resources and Teams’ Experience

et al. 2019

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The Alliance of Independent Academic Medical Centers (AIAMC) organized and coordinated a multicenter learning collaborative, National Initiative V (NI V), focused on community health and health inequity. A pre–post descriptive study was designed to examine the outcomes of the AIAMC NI V. Data were collected from pre- and post-assessment surveys as well as a project milestone self-assessment survey. Twenty-nine institutions participated. By the conclusion of the NI, the majority of institutions had completed at least 1 of the milestones in each of the pre-work/background (65.52%), measurement (62.07%), methods (62.07%), and implement/sustain (20.69%) domains. Institutions reported a significant association between their readiness assessments prior to the start of the NI compared with their status of activities on completion. Milestone achievement is significantly associated with 3 of the assessment items. Learning collaboratives with thoughtfully integrated structure and support can be impactful on topic readiness for the participating organizations.

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Designing Quality Improvement Collaboratives for Dissemination: Lessons from a Multiple Case Study of the Implementation of Obstetric Emergency Safety Bundles

Walker¹,

DePuccio²,

Huerta³

et al. 2020

The Joint Commission Journal on Quality and Patient Safety

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Perspectives on Implementing Quality Improvement Collaboratives Effectively: Qualitative Findings from the CHIPRA Quality Demonstration Grant Program

Cited by 6 publications

References 18 publications

Impact of Statewide Prevention and Reduction of Clostridioides difficile (SPARC), a Maryland public health–academic collaborative: an evaluation of a quality improvement intervention

Impact of Statewide Prevention and Reduction of Clostridioides difficile (SPARC), a Maryland public health–academic collaborative: an evaluation of a quality improvement intervention

Learning Collaboratives in Medical Education: Exploring the Impact of Collaboratives’ Structure and Resources and Teams’ Experience

Designing Quality Improvement Collaboratives for Dissemination: Lessons from a Multiple Case Study of the Implementation of Obstetric Emergency Safety Bundles

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