Evaluating clinician‐led quality improvement initiatives: A system‐wide embedded research partnership at Stanford Medicine

Abstract

Introduction: Many healthcare delivery systems have developed clinician-led quality improvement (QI) initiatives but fewer have also developed in-house evaluation units. Engagement between the two entities creates unique opportunities. Stanford Medicine funded a collaboration between their Improvement Capability Development Program (ICDP), which coordinates and incentivizes clinician-led QI efforts, and the Evaluation Sciences Unit (ESU), a multidisciplinary group of embedded researchers with expertise in implementation and evaluation sciences. Aim: To describe the ICDP-ESU partnership and report key learnings from the first 2 y of operation September 2019 to August 2021.Methods: Department-level physician and operational QI leaders were offered an ESU consultation to workshop design, methods, and overall scope of their annual QI projects. A steering committee of high-level stakeholders from operational, clinical, and research perspectives subsequently selected three projects for indepth partnered evaluation with the ESU based on evaluability, importance to the health system, and broader relevance. Selected project teams met regularly with the ESU to develop mixed methods evaluations informed by relevant implementation science frameworks, while aligning the evaluation approach with the clinical teams' QI goals.Results: Sixty and 62 ICDP projects were initiated during the 2 cycles, respectively, across 18 departments, of which ESU consulted with 15 (83%). Within each annual cycle, evaluators made actionable, summative findings rapidly available to partners to inform ongoing improvement. Other reported benefits of the partnership included rapid adaptation to COVID-19 needs, expanded clinician evaluation skills, external knowledge dissemination through scholarship, and

Learn to fly: Training and competencies to support the multidisciplinary workforce needs of learning health systems

“…In “Continuous Quality Improvement at the Frontline: One Interdisciplinary Clinical Team's 4‐year Journey After Completing a Virtual Learning Program,” Robinson and colleagues 14 describe their experience and outcomes from a virtual coaching program and hands‐on curriculum designed to support capacity building for continuous QI activities, a hallmark of LHSs. A unique partnership to support QI is described in the article by Vilendrer and colleagues 15 : “Evaluating Clinician‐Led Quality Improvement Initiatives: A System‐Wide Embedded Research Partnership at Stanford Medicine.” This article describes engagement and partnership between the unit charged with coordinating clinician‐led QI projects with an in‐house implementation and evaluation unit. Finally, Masica and colleagues 16 offer readers an opportunity to consider LHS workforce development in the context of translational science in “The Texas Health Resources Clinical Scholars Program: Learning Health Care System Workforce Development through Embedded Translational Research.” Here, a collaboration between a large, non‐profit health system and a large academic medical center to launch a Clinical Scholars Program supports workforce development focused upon later‐stage translational research and engagement with community partners.…”

“…In "Continuous Quality Improvement at the Frontline: One Interdisciplinary Clinical Team's 4-year Journey After Completing a Virtual Learning Program," Robinson and colleagues 14 describe their experience and outcomes from a virtual coaching program and hands-on curriculum designed to support capacity building for continuous QI activities, a hallmark of LHSs. A unique partnership to support QI is described in the article by Vilendrer and colleagues 15 • How do we define success at the level of the trainee, the trainers, institutions, and the healthcare system writ large?…”