Building and launching an online quality improvement information exchange for home visiting programs in Missouri

Abstract

Continuous quality improvement initiatives (CQII) in home visiting programs have traditionally occurred within a local implementing agency (LIA), parent organization, or funding provision. In Missouri, certain LIAs participate in the Missouri Maternal, Infant, and Early Childhood Home Visiting program (MIECHV). Their CQII activities and the coordination of CQI efforts across agencies are limited to quarterly meetings to discuss barriers to service delivery and newsletters. Their designed CQI process does not include evaluation of program fidelity or assessment nor supports to assist with identifying and prioritizing areas where improvement is needed. Therefore, much of LIA CQII are often lost to the benefit of external agencies facing similar challenges. We developed a virtual environment, the Missouri MIECHV Gateway, for CQII activities. The Gateway promotes and supports quality improvement for LIAs while aligning stakeholders from seven home visiting LIAs. Development of the Gateway environment aims to complement the existing MIECHV CQI framework by: 1) adding CQI elements that are missing or ineffective, 2) adding elements for CQI identification and program evaluation, and 3) offering LIAs a network to share CQI experiences and collaborate at a distance. This web-based environment allows LIA personnel to identify program activities in need of quality improvement, and guides the planning, implementation, and evaluation of CQII. In addition, the Gateway standardizes quality improvement training, collates overlapping resources, and supports knowledge translation, thus aimed to improve capacity for measurable change in organizational initiatives. This interactive web-based portal provides the infrastructure to virtually connect and engage LIAs in CQI and stimulate sharing of ideas and best practices. This article describes the characteristics, development, build, and launch of this quality improvement practice exchange virtual environment and present results of three usability pilot tests and the site launch. Briefly, prior to deployment to 58 users, usability pilot testing of the site occurred in three stages, to three defined groups. Pilot testing results were overall positive, desirable, and vital to improving the site prior to the full-launch. The majority of reviewers stated they would access and use the learning materials (87%), use the site for completing CQII (80%), and reported that the site will benefit their work teams in addressing agency challenges (66%). The majority of reviewers also approved of the developed fidelity assessment: as, easy to use (79%), having a clear purpose (86%), providing value in selfidentification of CQII (75%), and recommendations were appropriate (79%). The System Usability Scale (SUS) score increased (10%) between pilot groups 2 and 3, with a mean SUS score of 71.6, above

Virtual adaptation of healthcare quality improvement training programmes in response to COVID-19: A rapid narrative review

“…Most studies had a mixed methods design and 18 of the 19 studies were based in the United States. Design of the interventions was also variable; most studies used a blended learning method combining online and in-person modes while only six studies [17,22,27,30,32,33] were entirely delivered online. Some blended learning modules conducted classroom-based sessions followed by support through online modules and QI project completion, while others used a ipped curriculum approach where participants completed online modules prior to the in person sessions such as seminars, workshops, lectures and QI project completion.…”

“…The online delivery modes used by studies included online modules [14-16, 20, 23, 24, 28-31, 34], access to web-based curricula [17], virtual learning environments [18], webinars [19,30,32], calls [19,32], web-based QI portals [22], smartphone apps [27], emails [27,33], access to package of tools [30] provides a standardised methodology which does not require prior faculty pro ciency or entail an increase in educational time commitment [20]. The IHI methodology is designed to help organizations in identifying and closing gaps via a standard improvement methodology [32].…”

“…One study used Adobe Connect and blackboard for delivering a web-based QI curriculum [17] while for a digital storytelling pedagogy, researchers recommended participants to use freely available software such as Windows Moviemaker or Apple i-movie [18]. Another QI collaborative used iLab which is a secure, online workspace [19] while a study that developed a webbased QI portal used WordPress CMS platform, social media account integration and a network management site called Hootsuite [22]. A microlearning app called Qstream was used in another training programme [27].…”

“…Studies used various evaluation methods; some focused on programme level factors such as course completion rates [16,27], learner reaction to training [14,17,25,32], engagement level of participants [14,28,33], participant perceptions of the online module content and quality [20], preferred training delivery mode [16,22,27] and document and report submission by participating teams [32]. Another area of outcome evaluation was improvement in participant knowledge.…”

“…Most of the included studies reported achieving desired outcomes such as increased QI knowledge & skills [14,24,25,27,28,34,35], positive reaction from participants towards the training [17,19,20,32], implementation of QI knowledge by participants [18,29] and con dence to use the learned skills in future [22,28]. One study reported no improvement in the measure being tracked [32].…”