"Ethics? But It's Only Quality Improvement!"

Flaming, Don; Barrett-Smith, Linda; Brown, Norma; Corcoran, Judy

doi:10.12927/hcq.2009.20661

Cited by 9 publications

(6 citation statements)

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“…While some ambiguity exists in relation to the definitions of quality improvement, implementation research, and evaluation projects in relation to the need for formal ethical approval [88,89], this study will be generating primary data. Following the principles of good research practice [90,91], ethical approval will be sought from a multi-site research ethics committee for data collection from phase two onwards.…”

Section: Methodology and Methodsmentioning

confidence: 99%

Implementing health research through academic and clinical partnerships: a realistic evaluation of the Collaborations for Leadership in Applied Health Research and Care (CLAHRC)

et al. 2011

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BackgroundThe English National Health Service has made a major investment in nine partnerships between higher education institutions and local health services called Collaborations for Leadership in Applied Health Research and Care (CLAHRC). They have been funded to increase capacity and capability to produce and implement research through sustained interactions between academics and health services. CLAHRCs provide a natural 'test bed' for exploring questions about research implementation within a partnership model of delivery. This protocol describes an externally funded evaluation that focuses on implementation mechanisms and processes within three CLAHRCs. It seeks to uncover what works, for whom, how, and in what circumstances.Design and methodsThis study is a longitudinal three-phase, multi-method realistic evaluation, which deliberately aims to explore the boundaries around knowledge use in context. The evaluation funder wishes to see it conducted for the process of learning, not for judging performance. The study is underpinned by a conceptual framework that combines the Promoting Action on Research Implementation in Health Services and Knowledge to Action frameworks to reflect the complexities of implementation. Three participating CLARHCS will provide in-depth comparative case studies of research implementation using multiple data collection methods including interviews, observation, documents, and publicly available data to test and refine hypotheses over four rounds of data collection. We will test the wider applicability of emerging findings with a wider community using an interpretative forum.DiscussionThe idea that collaboration between academics and services might lead to more applicable health research that is actually used in practice is theoretically and intuitively appealing; however the evidence for it is limited. Our evaluation is designed to capture the processes and impacts of collaborative approaches for implementing research, and therefore should contribute to the evidence base about an increasingly popular (e.g., Mode two, integrated knowledge transfer, interactive research), but poorly understood approach to knowledge translation. Additionally we hope to develop approaches for evaluating implementation processes and impacts particularly with respect to integrated stakeholder involvement.

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Section: Methodology and Methodsmentioning

confidence: 99%

Implementing health research through academic and clinical partnerships: a realistic evaluation of the Collaborations for Leadership in Applied Health Research and Care (CLAHRC)

et al. 2011

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“…However, because many projects were patient-centered, it still is important to report how potential ethical problems were mitigated to allow these projects to be easily replicated in other health care settings. This oversight appears to be a common problem, well described in the literature with Flaming et al 38 describing 6 ethical considerations for QUIPs.…”

Section: Discussionmentioning

confidence: 99%

Can Medical Students Lead Effective Quality Improvement Initiatives? A Systematic Review

Sayma

Saleh

et al. 2018

Am J Med Qual

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Quality improvement project (QUIP) concepts are becoming embedded into medical school curricula, with many students now expected to conduct a QUIP as part of their progression. This study aimed to assess whether student-led QUIPs can be effective and sustainable. A systematic literature search was conducted using 5 databases: MEDLINE, Embase, Ovid, CINAHL, and PsycINFO. The authors searched for articles published between January 28, 1978, and January 28, 2018. In all, 3965 articles were identified through database searching, and an additional 9 articles through hand searches. After screening and full-text analysis, 12 articles were included. Greater than 50% of QUIPs described a statistically significant improvement in the primary outcome. However, effective student-led QUIPs were not necessarily sustainable, with a mean final audit at 4.4 months. Medical students have the potential to produce effective QUIPs. There now needs to be a structured approach to give medical students the freedom to test and validate more unique interventions.

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“…The requirement to submit quality improvement activities to an Ethics Committee can be a disincentive, as activities like the APOP DUE do not involve release of any identified information, and are designed to assist the hospital improve its own activities (Lynn et al., ). There is some confusion about the requirement for ethical approval in these quality improvement situations and interpretations vary from institution to institution (Flaming, Barrett‐Smith, Brown, & Corcoran, ; Lynn et al., ). Perhaps improving the understanding of the quality improvement process may help some hospitals to participate more readily.…”

Section: Discussionmentioning

confidence: 99%

Innovation in Hospital Quality Improvement Activities—Acute Postoperative Pain Management (APOP) Self-Help Toolkit Audits as an Example

Pulver¹,

Oliver²,

Tett³

2012

Journal for Healthcare Quality

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It is often difficult to maintain quality improvement change. Many behavioral strategies have been used to improve uptake of new practices and knowledge. One effective way of changing medication prescribing is audit and feedback with specific educational feedback. The challenge however is to maintain ongoing quality improvement activities. In Australia, unique downloadable "toolkits" are now available to assist hospitals to maintain prescribing quality improvement activities. The first designed to improve the management of acute postoperative pain (APOP toolkit) has been piloted. The toolkit includes data collection and educational tools, an automated feedback report on key indicators, with complete instructions for use. The APOP toolkit has been used in 73 hospitals, in two facilitated "snapshot" audits. There was continued improvement in performance, assessed by increases in the percentage of patients with measured pain and sedation scores and in those with documented pain management plans at discharge, compared with earlier APOP project audits. Using this example of the APOP toolkit and "snapshot" audits, we have now demonstrated that hospitals nationwide are able to undertake quality improvement activities voluntarily to maintain optimal performance. Encouragement, guidance, and availability of ready-made tools developed by a national team facilitate opportunities for ongoing quality improvements.

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"Ethics? But It's Only Quality Improvement!"

Cited by 9 publications

References 0 publications

Implementing health research through academic and clinical partnerships: a realistic evaluation of the Collaborations for Leadership in Applied Health Research and Care (CLAHRC)

Implementing health research through academic and clinical partnerships: a realistic evaluation of the Collaborations for Leadership in Applied Health Research and Care (CLAHRC)

Can Medical Students Lead Effective Quality Improvement Initiatives? A Systematic Review

Innovation in Hospital Quality Improvement Activities—Acute Postoperative Pain Management (APOP) Self-Help Toolkit Audits as an Example

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